四种评分系统的评估与验证：急性生理与慢性健康状况评分系统IV（APACHE IV）、序贯器官衰竭评估（SAPS III）、第二代多器官功能不全评分（MPM0 II）以及危重症癌症患者综合评分（ICMM）
Evaluation and Validation of Four Scoring Systems: the APACHE IV, SAPS III, MPM0 II, and ICMM in Critically Ill Cancer Patients.
作者信息
Siddiqui Suhail S, Narkhede Amit M, Kulkarni Atul P, Prabu Natesh R, Chaudhari Harish K, Sarode Satish V, Divatia Jigeeshu V
机构信息
Department of Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
Division of Critical Care Medicine, Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
出版信息
Indian J Crit Care Med. 2020 Apr;24(4):263-269. doi: 10.5005/jp-journals-10071-23407.
BACKGROUND AND AIMS
To evaluate and validate four severity-of-illness scores, acute physiology and chronic health evaluation IV (APACHE IV), simplified acute physiology score III (SAPS III), mortality probability models II at 0 hours (MPM0 II), and ICU cancer mortality model (ICMM), in a prospective cohort of critically ill cancer patients.
MATERIALS AND METHODS
Single-center, prospective observational study performed in a 14-bedded combined medical-surgical ICU of a tertiary care cancer center of India, from July 2014 to November 2015. Score performance was judged by discrimination and calibration, using the area under receiver-operating characteristics (ROC) curve and Hosmer-Lemeshow goodness-of-fit test, respectively.
RESULTS
A total of 431 patients were included in the study. Intensive care unit (ICU) and hospital mortality were 37.4% and 41.1%, respectively. The area under ROC curve for APACHE IV, SAPS III, MPM0 II, and ICMM were 0.73, 0.70, 0.67, and 0.67, respectively. Calibration as calculated by Hosmer-Lemeshow analysis type C statistics for APACHE IV, SAPS III, MPM0 II, and ICMM shows good calibration with Chi-square values of 5.32, 9.285, 9.873, and 9.855 and values of 0.723, 0.319, 0.274, and 0.275, respectively.
CONCLUSION
All the four models had moderate discrimination and good calibration. However, none of the mortality prediction models could accurately discriminate between survivors and nonsurvivors in our patients.
HOW TO CITE THIS ARTICLE
Siddiqui SS, Narkhede AM, Kulkarni AP, Prabu NR, Chaudhari HK, Divatia JV, Evaluation and Validation of Four Scoring Systems: the APACHE IV, SAPS III, MPM0 II, and ICMM in Critically Ill Cancer Patients. Indian J Crit Care Med 2020;24(4):263-269.
背景与目的
在一组危重症癌症患者的前瞻性队列中，评估并验证四种疾病严重程度评分系统，即急性生理与慢性健康状况评分系统IV（APACHE IV）、简化急性生理学评分系统III（SAPS III）、0小时死亡概率模型II（MPM0 II）和重症监护病房癌症死亡模型（ICMM）。
材料与方法
于2014年7月至2015年11月，在印度一家三级护理癌症中心拥有14张床位的内科 - 外科联合重症监护病房进行单中心前瞻性观察性研究。分别使用受试者操作特征曲线（ROC）下面积和Hosmer-Lemeshow拟合优度检验，通过区分度和校准来判断评分系统的性能。
结果
共有431例患者纳入研究。重症监护病房（ICU）死亡率和医院死亡率分别为37.4%和41.1%。APACHE IV、SAPS III、MPM0 II和ICMM的ROC曲线下面积分别为0.73、0.70、0.67和0.67。通过Hosmer-Lemeshow分析C型统计量计算的APACHE IV、SAPS III、MPM0 II和ICMM的校准显示校准良好，卡方值分别为5.32、9.285、9.873和9.855，P值分别为0.723、0.319、0.274和0.275。
结论
所有这四种模型都具有中等区分度和良好校准。然而，在我们的患者中，没有一个死亡率预测模型能够准确区分幸存者和非幸存者。
如何引用本文
Siddiqui SS, Narkhede AM, Kulkarni AP, Prabu NR, Chaudhari HK, Divatia JV, 四种评分系统的评估与验证：APACHE IV、SAPS III、MPM0 II和ICMM在危重症癌症患者中的应用。《印度重症医学杂志》2020；24(4):263 - 269。
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