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Citation |
Zhou YR, Hu XY, Yuan C, Zhao GJ, Hong GL, Li MF, Zhi SC, Lu ZQ. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2018; 36(11): 808-812. |
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Affiliation |
Emergency Department of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China. |
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Copyright |
(Copyright © 2018, Tianjin shi lao dong wei sheng yan jiu suo) |
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DOI |
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PMID |
30646640 |
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Abstract |
Objective: To compare the predictive value of PSS, APACHEII, SAPSII and SOFA in the prognosis evaluation of acute poisoning. Methods: Clinical data (including PSS score, APACHEII score, SAPSII score and SOFA score, within 24 hours after admission) of 231 acute poisoning patients admitted to the emergency intensive care unit EICU of our hospital from January 2015 to October 2016 was retrospectively analyzed. The patients were divided into the survival group and the dead group according to the 28-day clinical outcomes, comparing the differences of clinical data in each group. To analyze the correlation between PSS score, APACHEII score, SAPSII score and SOFA score in each group, comparing the value and the area under the ROC curve of four scoring systems and evaluate the predictive value of the four scoring systems. Results: Comparing with the survival group and the dead group, PSS score, APACHEII score, SAPSII score and SOFA score were significantly different (P<0.01). PSS score, APACHEII score, SAPSII score and SOFA score were significantly positive correlation (P<0.01) , the area under the ROC curve (AUC) of the four scoring systems were 0.833, 0.887, 0.843 and 0.843 respectively. The area under the ROC curve (AUC) of APACHEII score was higher than PSS score, SAPSII score and SOFA score, the difference was statistically significant (z=2.351, 2.317, 2.217; P=0.019, 0.021, 0.027) , there was no significant difference in the area (AUC) between the three scoring curves (P>0.05). The cutoff value (cut-off) , sensitivity, specificity and accuracy rates of PSS score, APACHEII score, SAPSII score and SOFA score were (2.5, 93.1%, 50.9%, 61.5%) , (14.5, 82.8%, 75.7%, 77.48%) , (31.5, 77.6%, 76.90%, 77.08%) , (5.5, 77.60%, 74.60%, 75.35%). Conclusion: PSS score, APACHEII score, SAPSII score and SOFA score can evaluate the prognosis of patients with acute poisoning, but the APACHEII score is better than the other three scoring systems in evaluating the prognosis for its evaluation ability and accuracy rate. Language: zh 目的： 比较PSS、APACHEII、SAPSII、SOFA 4种评分系统在急性中毒预后评估中的价值。 方法： 回顾性分析2015年1月至2016年10月收住我院急诊重症监护室EICU的231例急性中毒患者的临床资料，收集入院24h内PSS评分、APACHEII评分、SAPSII评分、SOFA评分，根据28d临床结局分为存活组和死亡组，比较两组临床资料的差异，分析两组患者的的PSS评分、APACHEII评分、SAPSII评分、SOFA评分的相关性，并对4种评分系统分值及ROC曲线下面积进行比较，评估4种评分系统的预测价值。 结果： 与死亡组比较，存活组PSS评分、APACHEII评分、SAPSII评分、SOFA评分的差异有统计学意义（P<0.01）。PSS评分、APACHEII评分、SAPSII评分、SOFA评分之间呈明显正相关关系（P<0.01），4种评分系统的ROC曲线下面积（AUC）分别为0.833、0.887、0.843、0.843。APACHEII评分曲线下面积大于PSS评分、SAPSII评分、SOFA评分，差异有统计学意义（z=2.351，2.317，2.217；P=0.019，0.021，0.027），另3种评分曲线下面积（AUC）比较的差异无统计学意义（P>0.05）。PSS评分、APACHEII评分、SAPSII评分、SOFA评分截断值（cut-off）、灵敏度、特异度、准确率分别为（2.5，93.1%，50.9%，61.5%）、（14.5，82.8%，75.7%，77.48%）、（31.5，77.6%，76.90%，77.08%）、（5.5，77.60%，74.60%，75.35%）。 结论： 4种评分系统均可对急性中毒患者的预后进行评估，APACHEII评分对预后的评估能力及准确率优于其他3种评分系统。. Language: zh |
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Keywords |
Outcome scale; Poisoning; ROC corve |