APACHE II scoring to predict outcome in post-cardiac arrest.
APACHE II scoring to predict outcome in post-cardiac arrest.
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DOI：
10.1016/j.resuscitation.2012.10.024
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发表时间：
2013-05
期刊：
影响因子：
6.5
通讯作者：
Cocchi MN
中科院分区：
文献类型：
--
作者：
Donnino MW;Salciccioli JD;Dejam A;Giberson T;Giberson B;Cristia C;Gautam S;Cocchi MN
尽管心脏骤停的管理取得了进步，但死亡率仍然很高，并且很少有疾病严重程度评分系统在该人群中得到校准。当前调查的目标是评估心脏骤停后的急性生理学和慢性健康评估 II 评分。这是一项针对三级护理中心的成年心脏骤停后患者的前瞻性观察研究。主要结果变量是院内死亡率，次要结果变量是神经系统结果。 APACHE II 评分用于通过逻辑模型预测结果。总共 228 名受试者被纳入分析。该队列的中位年龄为 70 岁（IQR：64 – 71），32% (72/228) 的患者为女性。中位停机时间为 15 分钟（IQR：7 – 27），初始乳酸为 5.9 mmol/L（IQR：3.5 – 8.4）。 71 例 (57%) 死亡发生在 72 小时随访之前，总体院内死亡率为 55% (125/228)。所有心脏骤停患者的 APACHE II 评分的区分度从 0 小时到 72 小时随访逐步增加（AUC：0 小时：0.62；24 小时：0.75；48 小时：0.82；72 小时：0.86）。对于院外心脏骤停 (OHCA) 患者，APACHE II 评分在零时间时的结果预测效果较差，与危重患者评分的最初发展一致。对于零时间的院内心脏骤停 (IHCA) 以及 24 小时及之后的 IHCA 和 OHCA，APACHE II 评分是疾病严重程度的适度指标和死亡率/神经系统发病率的预测因子。
Despite advancements in management of cardiac arrest, mortality remains high and few severity of illness scoring systems have been calibrated in this population. The goal of the current investigation was to assess the Acute Physiology and Chronic Health Evaluation II score in post-cardiac arrest. This is a prospective observational study of adult post-cardiac arrest patients at a tertiary-care center. The primary outcome variable was in-hospital mortality and secondary outcome variable was neurologic outcome. APACHE II scores were used to predict outcomes using logistic modeling. A total of 228 subjects were included in the analysis. The median age of the cohort was 70 (IQR: 64 – 71) and 32% (72/228) of the patients were female. The median downtime was 15 minutes (IQR: 7 – 27) and initial lactate 5.9 mmol/L (IQR: 3.5 – 8.4). 71 (57%) of deaths occurred prior to the 72-hour follow-up and overall in-hospital mortality was 55% (125/228). Discrimination of APACHE II score in all cardiac arrest patients increased in stepwise fashion from 0-hr to 72-hr follow-up (AUC: 0-hr: 0.62; 24-hr: 0.75; 48-hr: 0.82; 72-hr: 0.86). APACHE II score is a poor predictor of outcome at time zero for out-of-hospital cardiac arrest (OHCA) post-arrest patients consistent with the original development of the score in the critically ill. For in-hospital cardiac arrest (IHCA) at time zero and for both IHCA and OHCA at 24 hours and beyond, the APACHE II score was a modest indicator of illness severity and predictor of mortality/neurologic morbidity.
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影响因子：
37.8
作者：
CUMMINS, RO;CHAMBERLAIN, DA;THIES, WH
通讯作者：
THIES, WH
影响因子：
3.7
作者：
Travaglino, Francesco;De Berardinis, Benedetta;Di Somma, Salvatore
通讯作者：
Di Somma, Salvatore
影响因子：
38.9
作者：
Laver, S;Farrow, C;Nolan, J
通讯作者：
Nolan, J
影响因子：
38.9
作者：
GIANGIULIANI, G;MANCINI, A;GUI, D
通讯作者：
GUI, D
DOI：
10.1007/s00063-011-0051-4
发表时间：
2012-02-01
影响因子：
1.1
作者：
Hettwer, S.;Wilhelm, J.;Werdan, K.
通讯作者：
Werdan, K.