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冠心病监护病房中急性生理与慢性健康状况评分系统(APACHE II)及扩展的简化急性生理学评分系统(SAPS II)死亡率评分系统的预测结果

Predictive outcomes of APACHE II and expanded SAPS II mortality scoring systems in coronary care unit.

作者信息

Kahraman Fatih, Yılmaz Ahmet Seyda, Ersoy İbrahim, Demir Mevlüt, Orhan Hikmet

机构信息

Cardiology Clinic, Kutahya Evliya Celebi Research and Training Hospital, Kutahya, Turkey.

Department of Cardiology, Recep Tayyip Erdogan University, Rize, Turkey.

出版信息

Int J Cardiol. 2023 Jan 15;371:427-431. doi: 10.1016/j.ijcard.2022.09.065. Epub 2022 Sep 29.

Abstract

OBJECTIVE

We investigated the predictive values of the expanded Simplified Acute Physiology Score (SAPS) II and Acute Physiologic Score and Chronic Health Evaluation (APACHE) II score in predicting in-hospital mortality in coronary care unit (CCU) patients.

METHODS

In this study, expanded SAPS II and APACHE II scores were calculated in the CCU of a single-center tertiary hospital. Patients admitted to CCU with any cardivascular indication were included in the study. Both scores were calculated according to previously determined criteria. Calibration and discrimination abilities of the scores in predicting in-hospital mortality were tested with Hosmer-Lemeshow goodness-of-fit C chi-square and receiver operating characteristics (ROC) curve analyses.

RESULTS

A total of 871 patients were included in the analysis. The goodness-of-fit C chi-square test showed that both scores have a good performance in predicting survivors and nonsurvivors in CCU. Expanded SAPS II score has a sensitivity of 80% and a specificity of 91.8% with the cut-off value of 5.55, while APACHE II has a sensitivity of 75.9% and a specificity of 87.4% with the cut-off value of 16.5 in predicting mortality.

CONCLUSION

Expanded SAPS II and APACHE II scores have good ability to predict in-hospital mortality in CCU patients. Therefore, they can be used as a tool to predict short-term mortality in cardiovascular emergencies.

摘要

目的

我们研究了扩展的简化急性生理学评分(SAPS)II和急性生理与慢性健康状况评分系统(APACHE)II在预测冠心病监护病房(CCU)患者院内死亡率方面的预测价值。

方法

在本研究中,在一家单中心三级医院的CCU中计算扩展的SAPS II和APACHE II评分。纳入因任何心血管指征入住CCU的患者。两个评分均根据先前确定的标准计算。通过Hosmer-Lemeshow拟合优度C卡方检验和受试者工作特征(ROC)曲线分析来测试评分在预测院内死亡率方面的校准和区分能力。

结果

共有871例患者纳入分析。拟合优度C卡方检验表明,两个评分在预测CCU中的存活者和非存活者方面均表现良好。在预测死亡率时,扩展的SAPS II评分的敏感性为80%,特异性为91.8%,截断值为5.55;而APACHE II评分的敏感性为75.9%,特异性为87.4%,截断值为16.5。

结论

扩展的SAPS II和APACHE II评分在预测CCU患者院内死亡率方面具有良好的能力。因此,它们可作为预测心血管急症短期死亡率的工具。

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