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[简化急性生理学评分(SAPS)-II评分参数对重症监护患者治疗时长的预测价值]

[Predictive value of score parameters of the Simplified Acute Physiology Score (SAPS)-II for the duration of treatment of intensive care patients].

作者信息

Schuster H P, Wilts S, Ritschel P, Schuster F P

机构信息

Medizinische Klinik I, Städtisches Krankenhaus Hildesheim, Akademisches Lehrkrankenhaus, Bundesrepublik Deutschland.

出版信息

Wien Klin Wochenschr. 1996;108(15):462-6.

PMID:8967089
Abstract

Length of intensive care therapy and the total length of stay in hospital are important determinants of hospital costs. We therefore analysed the correlation between score parameters of SAPS-II with the time spent in the intensive care unit (ICU), and also in the hospital, for 604 general medical intensive care patients (ICU group) and 510 coronary care patients (CCU group). The mean stay in the ICU was 3.68 days for ICU patients and 2.67 days for CCU patients. The total stay in hospital was 13.5 days vs 16.1 days with a mortality of 18% (risk of death 0.21) in ICU and 10% (risk of death 0.13) in CCU patients. In patients who died, duration of therapy in the ICU was significantly longer than in surviving patients (5.88 vs 3.20 days in the ICU group and 3.65 vs 2.56 days in the CCU group). In contrast, total hospital stay was significantly shorter in patients who died (8.6 vs 14.5 days in the ICU group and 8.8 vs 16.9 days in the CCU group) (p = 0.001). The risk of death calculated from SAPS II was significantly correlated with the duration of intensive care. There was a significant indirect correlation between risk of death and the total hospital stay. In ICU patients duration of intensive treatment and hospital stay correlated with age, heart rate, maximum systolic blood pressure, body temperature, BUN, serum bilirubin, and sodium (all signs of systemic inflammatory reaction and organ dysfunction); in CCU patients length of intensive treatment and hospital stay correlated with body temperature, diuresis, BUN, bicarbonate, minimum systolic blood pressure (as signs of organ perfusion). A low Glasgow Coma Score was correlated with prolonged intensive care in all patients. In conclusion, score data, appear a suitable tool to predict the duration of intensive care treatment and length of hospitalization, in addition to outcome, and thus serve as gauge of efficiency.

摘要

重症监护治疗的时长以及住院总时长是医院成本的重要决定因素。因此,我们分析了604例普通内科重症监护患者(ICU组)和510例冠心病监护病房患者(CCU组)的序贯器官衰竭评估(SAPS-II)评分参数与在重症监护病房(ICU)以及住院时长之间的相关性。ICU患者在ICU的平均住院时间为3.68天,CCU患者为2.67天。住院总时长分别为13.5天和16.1天,ICU患者死亡率为18%(死亡风险0.21),CCU患者死亡率为10%(死亡风险0.13)。在死亡患者中,ICU的治疗时长显著长于存活患者(ICU组为5.88天对3.20天,CCU组为3.65天对2.56天)。相比之下,死亡患者的住院总时长显著缩短(ICU组为8.6天对14.5天,CCU组为8.8天对16.9天)(p = 0.001)。根据SAPS II计算出的死亡风险与重症监护时长显著相关。死亡风险与住院总时长之间存在显著的间接相关性。在ICU患者中,强化治疗时长和住院时长与年龄、心率、最高收缩压、体温、血尿素氮、血清胆红素和钠(所有全身炎症反应和器官功能障碍的体征)相关;在CCU患者中,强化治疗时长和住院时长与体温、尿量、血尿素氮、碳酸氢盐、最低收缩压(作为器官灌注的体征)相关。所有患者中,低格拉斯哥昏迷评分与延长的重症监护相关。总之,评分数据似乎是预测重症监护治疗时长、住院时长以及预后的合适工具,因此可作为效率的衡量标准。

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