Effectiveness of the sequential organ failure assessment, acute physiology and chronic health evaluation II, and simplified acute physiology score II prognostic scoring systems in paraquat-poisoned patients in the intensive care unit
Effectiveness of the sequential organ failure assessment, acute physiology and chronic health evaluation II, and simplified acute physiology score II prognostic scoring systems in paraquat-poisoned patients in the intensive care unit
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DOI：
10.1177/0960327116657602
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发表时间：
2017-05-01
影响因子：
2.8
通讯作者：
Kim, Yong Hwan
中科院分区：
文献类型：
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作者：
Lee, Jun Ho;Hwang, Seong Youn;Kim, Yong Hwan
目的：本研究旨在评估序贯器官衰竭评估（SOFA）和急性生理学和慢性健康评估（APACHE）II评分系统以及简化急性生理学评分（SAPS）II方法预测百草枯中毒重症监护病房（ICU）患者群体死亡率的能力。材料与方法：回顾性分析2010年1月至2015年4月收治的244例百草枯中毒患者的病历资料。SOFA、APACHE II和SAPS II评分根据急诊科和ICU入院前24小时的初始实验室数据计算。根据SOFA评分、APACHE II评分和SAPS II计算每例患者的死亡概率。SOFA评分，APACHE II评分和SAPS II方法预测组死亡率的能力进行了评估，使用受试者工作特征（ROC）曲线和校准analysis.Results：共219例患者（平均年龄，63岁）。SOFA的敏感性、特异性和准确性分别为58.5%、86.1%和64.0%; APACHE II评分系统的敏感性、特异性和准确性分别为75.1%、86.1%和77.6%; SAPS II的敏感性、特异性和准确性分别为76.1%、79.1%和76.7%。SOFA评分、APACHE Ⅱ评分和SAPS Ⅱ的ROC曲线下面积分别为0.716、0.850和0.835。结论：SOFA评分、APACHE Ⅱ评分和SAPS Ⅱ对百草枯中毒患者早期住院死亡的判别和估计能力不同。我们的研究结果表明，虽然SOFA和SAPS II比APACHE II更容易和更快地计算，APACHE II是优越的预测死亡率的上级。我们建议使用APACHE II对ICU中百草枯中毒患者进行结局预测和风险分层。
Objective: This study was conducted to assess the ability of the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation (APACHE) II scoring systems, as well as the simplified acute physiology score (SAPS) II method to predict group mortality in intensive care unit (ICU) patients who were poisoned with paraquat. This will assist physicians with risk stratification.Material and methods: The medical records of 244 paraquat-poisoned patients admitted to the ICU from January 2010 to April 2015 were examined retrospectively. The SOFA, APACHE II, and SAPS II scores were calculated based on initial laboratory data in the emergency department and during the first 24 h of ICU admission. The probability of death was calculated for each patient based on the SOFA score, APACHE II score, and SAPS II. The ability of the SOFA score, APACHE II score, and SAPS II method to predict group mortality was assessed using a receiver operating characteristic (ROC) curve and calibration analyses.Results: A total of 219 patients (mean age, 63 years) were enrolled. Sensitivities, specificities, and accuracies were 58.5%, 86.1%, and 64.0% for the SOFA, respectively; 75.1%, 86.1%, and 77.6% for the APACHE II scoring systems, respectively; and 76.1%, 79.1%, and 76.7% for the SAPS II, respectively. The areas under the curve in the ROC curve analysis for the SOFA score, APACHE II scoring system, and SAPS II were 0.716, 0.850, and 0.835, respectively.Conclusion: The SOFA, APACHE II, and SAPS II had different capabilities to discriminate and estimate early in-hospital mortality of paraquat-poisoned patients. Our results show that although the SOFA and SAPS II are easier and more quickly calculated than APACHE II, the APACHE II is superior for predicting mortality. We recommend use of the APACHE II for outcome predictions and risk stratification in paraquat-poisoned patients in the ICU.