急性生理学和慢性健康评估II评分和序贯器官衰竭评估评分作为重症监护室严重创伤患者的预测指标

Min A Lee, K. Choi, B. Yu, Jae Jeong Park, Youngeun Park, Jihun Gwak, Jungnam Lee, Y. Jeon, D. Ma, G. Lee
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引用次数: 8

摘要

背景急性生理与慢性健康评估(APACHE) II评分系统和序期器官衰竭评估(SOFA)评分系统被广泛应用于危重患者。我们评估了APACHE II评分和SOFA评分是否能预测重症监护病房(ICU)创伤患者的预后。方法回顾性分析2014年1月至2015年12月在某外伤中心ICU收治的外伤患者。根据入院前24小时的数据计算APACHE II评分;SOFA评分基于患者在ICU的前3天进行评估。共有241例患者可用于分析。评估损伤严重程度评分、APACHE II评分和SOFA评分。结果总生存率为83.4%。非生存组入院时APACHEⅱ评分(24.1±8.1比12.3±7.2,P < 0.001)和SOFA评分(7.7±1.7比4.3±1.9,P < 0.001)均显著较高。SOFA评分曲线下面积最大(0.904)。在前3天,非生存组的SOFA评分仍然很高。在非生存组中,心血管系统、神经系统、肾脏系统和凝血系统评分明显较高。结论在ICU创伤患者中,SOFA和APACHE II评分均能很好地预测预后,其中SOFA评分最有效。在创伤ICU患者中,应补充创伤评分系统,认识到多器官功能衰竭是死亡率的重要因素。
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Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment Score as Predictors for Severe Trauma Patients in the Intensive Care Unit
Background The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). Methods We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. Results The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. Conclusions In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
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