Combining multiple comorbidities with Acute Physiology Score to predict hospital mortality of critically ill patients: a linked data cohort study
Combining multiple comorbidities with Acute Physiology Score to predict hospital mortality of critically ill patients: a linked data cohort study
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DOI：
10.1111/j.1365-2044.2007.05231.x
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发表时间：
2007-11-01
期刊：
影响因子：
10.7
通讯作者：
Webb, S. A. R.
中科院分区：
文献类型：
--
作者：
Ho, K. M.;Finn, J.;Webb, S. A. R.
我们研究了用其他既往合并症指标替代急性生理学和慢性健康评估（APACHE）II加权合并症评分是否能提高对危重患者住院死亡率的预测。将24303例危重患者的临床数据与西澳大利亚医院发病率数据库相关联，以确定既往合并症。Charlson合并症指数和Elixhauser合并症中描述的轻微合并症在重症患者中普遍存在。在24303例住院患者中，分别有3615例（14.9%）、10223例（42.1%）和11597例（47.7%）患者至少有一种APACHE II评分、Charlson合并症指数和Elixhauser合并症定义的合并症。仅合并症区分住院幸存者和非幸存者的能力很差。用其他更全面的合并症指标代替APACHE II加权合并症评分并不能显著提高APACHE II评分的区分度。
We investigated whether replacing the Acute Physiology and Chronic Health Evaluation (APACHE) II weighted comorbidity score with other measures of prior comorbidity would improve the prediction of hospital mortality in critically ill patients. Clinical data of 24 303 critically ill patients were linked to the Western Australian hospital morbidity database to identify prior comorbidities. Minor comorbidities as described in the Charlson comorbidity index and Elixhauser comorbidities were prevalent in critically ill patients. Among 24 303 admissions, 3615 (14.9%), 10 223 (42.1%), and 11 597 (47.7%) patients had at least one comorbidity as defined in the APACHE II score, Charlson comorbidity index, and Elixhauser comorbidities, respectively. The ability of comorbidity alone to discriminate between hospital survivors and non-survivors was poor. Replacing the APACHE II weighted comorbidity score with other more comprehensive measures of comorbidity did not significantly improve the discrimination of the APACHE II score.