Establishment and effectiveness evaluation of a scoring system for exertional heat stroke by retrospective analysis
Establishment and effectiveness evaluation of a scoring system for exertional heat stroke by retrospective analysis
复制标题
劳力性中暑评分系统的建立及有效性评价
DOI：
10.1186/s40779-020-00269-1
复制
发表时间：
2020-08-27
影响因子：
21.1
通讯作者：
Kang, Hong-Jun
中科院分区：
文献类型：
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作者：
Yang, Meng-Meng;Wang, Lu;Kang, Hong-Jun
背景中暑(HS)是一种严重威胁生命的疾病。然而，到目前为止，HS还没有评分系统。方法收集2005年至2016年中国全市52家医院170例体力中暑患者的临床资料。采用单变量统计方法和受试者工作特征(ROC)曲线下面积(AUC)比较筛选运动性中暑评分(EHSS)参数，包括但不限于体温(T)、格拉斯哥昏迷评分(GCS)等。结果通过上述方法筛选，本研究确定了体温(T)、GCS、pH、乳酸(Lac)、血小板计数(PLT)、凝血酶原时间(PT)、纤维蛋白原(Fib)、肌钙蛋白I(TnI)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、肌酐(Cr)和急性胃肠道损伤(AGI)等12项参数作为EHSS参数。这是一个0-47分的系统，旨在反映日益严重的中暑。低(EHSS<； 20)和高(EHSS>； 35)分别显示100%的存活率和100%的死亡率。结论T、GCS、pH、Lac、PLT、PT、Fib、TnI、AST、TBIL、Cr、胃肠AGI分级等12项指标是评价EHS患者预后最有效的指标。随着EHSS评分的增加，EHS患者的死亡率逐渐增加。
BackgroundHeat stroke (HS) is a serious, life-threatening disease. However, there is no scoring system for HS so far. This research is to establish a scoring system that can quantitatively assess the severity of exertional heat stroke (EHS).MethodsData were collected from a total of 170 exertional heat stroke (EHS) patients between 2005 and 2016 from 52 hospitals in China. Univariate statistical methods and comparison of the area under the receiver operating characteristic (ROC) curve (AUC) were used to screen exertional heat stroke score (EHSS) parameters, including but not limited body temperature (T), Glasgow Coma Scale (GCS) and others. By comparing the sizes of the AUCs of the APACHE II, SOFA and EHSS assessments, the effectiveness of EHSS in evaluating the prognosis of EHS patients was verified.ResultsThrough screening with a series of methods, as described above, the present study determined 12 parameters – body temperature (T), GCS, pH, lactate (Lac), platelet count (PLT), prothrombin time (PT), fibrinogen (Fib), troponin I (TnI), aspartate aminotransferase (AST), total bilirubin (TBIL), creatinine (Cr) and acute gastrointestinal injury (AGI) classification – as EHSS parameters. It is a 0–47 point system designed to reflect increasing severity of heat stroke. Low (EHSS< 20) and high scores (EHSS> 35) showed 100% survival and 100% mortality, respectively. We found that AUCEHSS > AUCSOFA > AUCAPACHE II.ConclusionA total of 12 parameters – T, GCS, pH, Lac, PLT, PT, Fib, TnI, AST, TBIL, Cr and gastrointestinal AGI classification – are the EHSS parameters with the best effectiveness in evaluating the prognosis of EHS patients. As EHSS score increases, the mortality rate of EHS patients gradually increases.