APACHE II score does not predict multiple organ failure or mortality in postoperative surgical patients.
APACHE II score does not predict multiple organ failure or mortality in postoperative surgical patients.
复制标题
APACHE II 评分不能预测术后患者的多器官衰竭或死亡率。
作者：
F. Cerra;Francesco Negro;J. Abrams
进行了一项临床研究，以评估APACHE(急性生理学和慢性卫生保健)II系统预测多器官衰竭综合征的发展和随后的死亡率的能力。这项研究是在一所大学的普外科重症监护病房进行的，使用的是入院APACHE II评分。在一年的时间里，92名患者符合研究条件，其中24人幸存，69人患有多器官衰竭综合征，68人死亡。APACHE II评分不能预测多器官衰竭综合征的发展或死亡率，也不具有临床实用价值，并且严重低估了多器官衰竭综合征的发展潜力。确实预测多器官衰竭综合征和死亡率的因素是PaO2与吸入氧的比例以及血清乳酸、肌酐和胆红素水平随时间的变化。在外科患者的决策和质量保证分析中，需要更好的细胞损伤标志物。
A clinical study was undertaken to evaluate the ability of the APACHE (acute physiology and chronic health care) II system to predict the development of multiple organ failure syndrome and subsequent mortality. The study was conducted in a university general surgery intensive care unit using the admission APACHE II score. Over a 1-year period, 92 patients qualified for the study, 24 of whom survived, 69 of whom suffered multiple organ failure syndrome, and 68 of whom died. The APACHE II score did not predict the development of multiple organ failure syndrome or mortality with clinical utility and significantly underestimated the potential for the development of multiple organ failure syndrome. Factors that did predict the development of multiple organ failure syndrome and mortality were the time-dependent changes in the PaO2-to-fraction of inspired oxygen ratio and serum lactate, creatinine, and bilirubin levels. Better markers of cell injury are needed for use in decision making and quality assurance analysis in surgical patients.