Rowan K M, Kerr J H, Major E, McPherson K, Short A, Vessey M P
Department of Public Health and Primary Care, University of Oxford, UK.
Crit Care Med. 1994 Sep;22(9):1392-401. doi: 10.1097/00003246-199409000-00007.
To compare the ability of two methods--Acute Physiology and Chronic Health Evaluation (APACHE II) and Mortality Prediction Model (MPM)--to predict hospital outcome for a large group of intensive care patients from Britain and Ireland.
Prospective, multicenter, cohort study.
Twenty-six general intensive care units in Britain and Ireland.
A total of 8,724 patients admitted to the study.
None.
Probabilities of hospital death for patients were estimated by applying APACHE II and MPM. Predicted risks of hospital death were compared with observed outcomes using four methods of assessing the overall goodness of fit. APACHE II performed better than MPM; the calibration curve for APACHE II lay closer to the line of perfect predictive ability. Lemeshow-Hosmer chi-square statistics were 81 and 57 for APACHE II, and 2515 and 1737 for MPM. The overall correct classification rate for APACHE II was 79%, and this classification rate was 74% for MPM, applying a decision criterion of 50%. The area under the receiver operating characteristic curve was 0.83 with APACHE II and 0.74 with MPM. Even after modifications to the MPM for the assessment of coma, the performance of APACHE II was superior.
APACHE II demonstrated a higher degree of overall goodness of fit, which was superior to MPM for groups of intensive care patients from Britain and Ireland.
比较急性生理与慢性健康状况评分系统（APACHE II）和死亡率预测模型（MPM）这两种方法预测来自英国和爱尔兰的一大群重症监护患者医院结局的能力。
前瞻性、多中心队列研究。
英国和爱尔兰的26个普通重症监护病房。
共有8724名患者纳入本研究。
无。
应用APACHE II和MPM估计患者的医院死亡概率。使用四种评估整体拟合优度的方法，将预测的医院死亡风险与观察到的结局进行比较。APACHE II的表现优于MPM；APACHE II的校准曲线更接近完美预测能力线。APACHE II的Lemeshow-Hosmer卡方统计量为81和57，MPM为2515和1737。采用50%的决策标准时，APACHE II的总体正确分类率为79%，MPM为74%。APACHE II的受试者工作特征曲线下面积为0.83，MPM为0.74。即使对MPM进行了昏迷评估方面的修正，APACHE II的表现仍更优。
对于来自英国和爱尔兰的重症监护患者群体，APACHE II显示出更高程度的整体拟合优度，优于MPM。
