Predictors of hospital mortality in a population-based cohort of patients with acute lung injury
Predictors of hospital mortality in a population-based cohort of patients with acute lung injury
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DOI：
10.1097/ccm.0b013e318170a375
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发表时间：
2008-05-01
影响因子：
8.8
通讯作者：
Rubenfeld, Gordon D.
中科院分区：
文献类型：
--
作者：
Cooke, Colin R.;Kahn, Jeremy M.;Rubenfeld, Gordon D.
目的：描述急性肺损伤患者死亡率预测因素的研究主要来自选定的学术中心。我们试图确定以人群为基础的急性肺损伤患者队列的死亡率预测因素，并表征该人群中当前疾病严重程度评分的表现。设计：对前瞻性、多中心、以人群为基础的队列进行二次分析。设置，华盛顿州的21家医院，病人。该队列包括1999-2000年间确诊的1113例急性肺损伤患者。干预措施:没有。测量和主要结果。我们评估了生理学、合并症、急性肺损伤的危险因素以及与出院死亡相关的其他变量。双变量死亡预测因子被输入到多元逻辑回归模型中。我们将急性生理和慢性健康评估（APACHE） II、APACHE III和简化急性生理评分II与多变量模型进行比较，使用受试者工作特征曲线下的面积。该模型在886例急性肺损伤患者的独立队列中得到验证。修正急性生理评分、年龄、合并症、动脉pH值、分钟通气量、PaCO2、PaO2/FIO2比、重症监护病房入院来源和急性肺损伤发病前重症监护病房天数是院内死亡的独立预测因子(p
Objective: Studies describing predictors of mortality in patients with acute lung injury were primarily derived from selected academic centers. We sought to determine the predictors of mortality in a population-based cohort of patients with acute lung injury and to characterize the performance of current severity of illness scores in this population..Design: Secondary analysis of a prospective, multicenter, population-based cohort.Setting, Twenty-one hospitals in Washington State.Patients. The cohort included 1,113 patients with acute lung injury identified during the year 1999-2000.Interventions: None.Measurements and Main Results. We evaluated physiology, comorbidities, risk factors for acute lung injury, and other variables for their association with death at hospital discharge. Bivariate predictors of death were entered into a multiple logistic regression model. We compared Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, and Simplified Acute Physiology Score II to the multivariable model using area under the receiver operating characteristic curve. The model was validated in an independent cohort of 886 patients with acute lung injury. Modified acute physiology score, age, comorbidities, arterial pH, minute ventilation, PaCO2, PaO2/FIO2 ratio, intensive care unit admission source, and intensive care unit days before onset of acute lung injury were independently predictive of in-hospital death (p