探讨APACHE II评分系统对EICU患者病情评估的效果

摘要

目的：探讨急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）对评估急诊重症监护病房（EICU）中危重患者的病情及判断其预后的应用价值。方法回顾性分析2012年6月至2013年3月期间收治的114例危重患者临床资料。根据患者预后，将其分为死亡组（57例）和存活组（57例），分别计算患者入科第1天、第3天及第5天的APACHEⅡ评分并行比较，并通过受试者工作特征曲线（ROC）下面积分析APACHE II 评分中的三个时间段对预后的评估价值及效果。结果死亡组患者入科第1天、第3天及第5天的的APACHE II 评分均高于存活组患者，分别为[（24.58±8.87）vs （16.42±6.70）；（25.76±8.59）vs（13.44±5.38）；（24.66±7.64）vs（12.11±4.22）]，两者比较差异有统计学意义（P<0.05），APACHE II 评分和患者预后有关。根据三组数据ROC曲线分析，对预后评估能力的大小依次为第5天、第3天、、第1天的APACHE II评分。结论 APACHE II评分系统可很好的评估EICU中危重患者的病情及预后，其中第5天的APACHE II评分能力最强。可为合理制定诊治计划和利用EICU资源提供参考。%Objective To assess the value of Acute physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scoring system in evaluating the condition of the patients in emergency intensive care unit(EICU). Method The clinical data of 114 cases of patients in EICU ward were retrospectively analyzed. These patients were hospitalized in the period from June 2012 to March 2013. According to the prognosis of patients,they were divided into the death group(57 cases)and survival group(57 cases). The APACHE II scores of the two groups’ patients were calculated on 1st,3rd,5th day after admission to the EICU and compared. The prognostic ability of APACHE II scoring systems in different day were assessed by the areas under the receiver operating characteristic curves(ROC). Results The three times of APACHE II scores of death group were higher than those of survival group. There had a relationships between the APACHE II scores and the prognosis.The data were (24.58±8.87vs 16.42±6.70; 25.76±8.59vs 13.44±5.38; 24.66±7.64vs 12.11±4.22),all of them were statistically significant difference(P<0.05). ROC curve analyzed based on three sets of data,to evaluate prognostic ability respectively. From big to small was the 5fth day of APACHE II scores,3rd day of APACHE II scores,and 1st day of APACHE II scores. Conclusions APACHE II score system could well evaluate the condition and prognosis of critically ill patients in EICU,the strongest of which was the 5th day of the APACHE II score. The Conclusions could develop a reasonable treatment plan and use of EICU resources reference.