Organ system failure scoring system can predict hospital mortality in critically ill cirrhotic patients
Organ system failure scoring system can predict hospital mortality in critically ill cirrhotic patients
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DOI：
10.1097/00004836-200309000-00011
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发表时间：
2003-09-01
影响因子：
2.9
通讯作者：
Chen, PC
中科院分区：
文献类型：
--
作者：
Tsai, MH;Chen, YC;Chen, PC
目标：本研究旨在评估和比较入住 ICU 第一天获得的 Child-Pugh 分类和器官系统衰竭 (OSF) 评分在预测危重肝硬化患者医院死亡率方面的准确性。背景：入住医疗重症监护室（ICU）的肝硬化患者死亡率较高。危重肝硬化患者的预后取决于肝脏及肝外器官功能障碍的程度。研究：2001 年 7 月至 2002 年 6 月期间，总共有 1 名诊断为肝硬化的患者入住内科 ICU。前瞻性收集了计算入住 ICU 第一天的 Child-Pugh 和 OSF 评分所必需的信息。结果：总体住院死亡率为64.9%。肝病最常见的原因是乙型肝炎病毒感染。 OSF 分数使用 Hosmer 和 Lemeshow 拟合优度检验证明了良好的拟合。同时，通过使用受试者工作特征曲线下面积（AUROC）曲线，OSF评分表现出出色的判别力（AUROC 0.901），而Child-Pugh评分的表现明显较差（AUROC 0.748）。结论：本次调查证实入住 ICU 的肝硬化患者预后很严重。 OSF评分是一种简单、重复性好、易于应用的工具，具有良好的预后能力，可以为患者家属和医生提供客观信息，补充临床对预后的判断。
Goals: This study was conducted to assess and compare the accuracy of Child-Pugh classification and organ system failure (OSF) scores, obtained on the first day of ICU admission, in predicting the hospital mortality in critically ill cirrhotic patients. Background: Cirrhotic patients admitted to the medical intensive care unit (ICU) are associated with high mortality rates. The prognosis of critically ill cirrhotic patients is determined by the extent of hepatic and extrahepatic organ dysfunction. Study: A total of I I I patients diagnosed with liver cirrhosis were admitted to medical ICU from July 2001 to June 2002. Information considered necessary to compute the Child-Pugh and OSF scores on the first day of ICU admission was prospectively collected. Results: The overall hospital mortality rate was 64.9%. Liver disease was most commonly attributed to hepatitis B viral infection. The OSF scores demonstrate a good fit using the Hosmer and Lemeshow goodness-of-fit test. Meanwhile, by using the areas under receiver operating characteristic (AUROC) curve, the OSF scores demonstrated an excellent discriminative power (AUROC 0.901), whereas the performance of Child-Pugh scores is clearly poorer (AUROC 0.748). Conclusion: This investigation confirms that the prognosis for cirrhotic patients admitted to ICU is grave. The OSF score is a simple, reproducible, and easily applied tool with excellent prognostic abilities that can provide objective information for patients' families and physicians and supplement the clinical judgment of prognosis.