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| 应用查尔森基础疾病权重指数评估脓毒症患者预后 |
| 王涛1,2,顾永辉1,3,崔云亮1,林兆奋1* |
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(1.第二军医大学长征医院急救科,上海 200003
2.解放军总医院海南分院急诊科,三亚 572000
3.江苏省老年医院重症医学科,南京 210024
*通信作者) |
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| 摘要: |
| 目的 探讨基础疾病评分系统查尔森基础疾病权重指数 (Charlson’s weighted index of comorbidities,WIC)评估脓毒症患者预后的价值。方法 回顾性分析3年收治的234例脓毒症患者的临床资料,计算WIC评分及急性病理生理和慢性健康状况评分Ⅱ(APACHEⅡ),根据28 d预后情况分为存活组和死亡组,分析WIC评分对患者预后的评估价值。结果 共有234例脓毒症患者纳入研究,死亡77例(32.9%)。WIC评分越高，患者的死亡风险越大；多因素logistic回归分析提示WIC评分是决定脓毒症患者预后的危险因素(OR=1.434,95% CI:1.097～1.875,P=0.008);WIC评分、APACHEⅡ评分以及两者联合预测死亡概率的ROC曲线下面积(95% CI)分别0.670(0.591～0.748)、0.770(0.703～0.837)和0.821(0.757～0.885)。结论 WIC评分可以较好地评估基础疾病对于危重病患者预后的影响。 |
| 关键词: 脓毒症 基础疾病 查尔森基础疾病权重指数 急性病理生理和慢性健康状况评分 |
| DOI： |
| 投稿时间：2012-12-18修订日期：2013-04-24 |
| 基金项目:上海市医学重点发展基金 |
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| Charlson’s weighted index of comorbidities in assessing prognosis of septic patients |
| WANG Tao1,2,GU Yong-hui1,3,CUI Yun-liang1 ,LIN Zhao-fen1* |
(1. Department of Emergency, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
2. Department of Emergency, Hainan Branch of PLA General Hospital, Sanya 572000, Hainan, China
3. ICU, Geriatric Hospital of Jiangsu Province, Nanjing 210024, Jiangsu, China
*Corresponding author.) |
| Abstract: |
| Objective To investigate the value of Charlson’s weighted index of comorbidities (WIC) in predicting the prognosis of patients with sepsis. Methods The clinical data of 234 septic patients in the last three years were retrospectively analyzed. The scores of WIC and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) were calculated. The patients were divided into two groups according to death or survival outcome 28 days later, and the value of WIC score in predicting prognosis was analyzed. Results It was found that 77 (32.9%) of the 234 patients died. Increasing WIC score was associated with increased mortality. Multiple logistic regression analysis revealed that WIC was a risk factor of prognosis of septic patients (OR=1.434, 95% CI:1.097-1.875, P=0.008). The areas under the ROC curves in predicting the mortality of the septic patients were 0.670 (0.591-0.748) for the WIC score, 0.770(0.703-0.837) for APACHEⅡ score and 0.821 (0.757-0.885) for the combination of both. Conclusion WIC score can satisfactorily predict the influence of underlying diseases on the prognosis of septic patients. |
| Key words: sepsis underlying diseases Charlson’s weighted index of comorbidities acute physical and chronic health evaluation score |
