感染相关的器官衰竭评分和多器官功能障碍评分对多器官功能障碍综合征预后判断的比较

Study comparing sepsis-related organ failure assessment and multiple organ dysfunction syndrome score to predict prognosis of MODS patients

目的比较感染相关的器官衰竭评分(SOFA)和多器官功能障碍评分(M arshallM ODS)评分对多器官功能障碍综合征病情严重度和预后判断的价值。方法对1981年1月至1998年1月的200例M ODS患者进行SOFA评分和M arshallM ODS评分。结果病死率与衰竭器官数目成正相关。在M arshallM ODS评分中,对预后影响最大的器官是心脏,其次是中枢神经系统,影响最小的是肝脏。在SOFA评分系统中对预后影响最大的是中枢神经系统,最小的是肝脏。除肝脏以外,其它五个系统的SOFA得分均显著高于M arshallM ODS得分。ROC曲线下面积M arshallM ODS评分为0.677,SOFA评分为0.651。结论两种评分系统都能反映M arshallM ODS患者的病情严重度和预后。SOFA评分对早期患者更适合,M ar鄄shallM ODS对循环系统功能的评价准确性更高。

Objective To evaluate the ability of two prognostic systems to predict of prognosis of MODS patients. Methods 200 MODS patients admitted to the department of infectious diseases and Critical Care Medicine from 1981 to 1998 were included in the study. Sepsis-related organ failure assessment(SOFA score) and multiple organ dysfunction syndrome score (MODS score) were retrospectively evaluated. Results The number of dysfunction organ exhibited a good correlation with MODS mortality. From MODS score, the cardiovascular system was associated with highest relative contribution to mortality, followed by CNS and live was the lowest. From SOFA score, CNS was associated with highest relative contribution to mortality and liver was lowest. Except liver, other dysfunction organ score were higher in SOFA score than that in MODS score. The area under ROC curve of MODS score and SOFA score was 0.677 and 0.651, respectively. Conclusion Both score system are quantify to prognoses the outcome of MODS patients. SOFA score is superior for MODS patients in early stage compared with MODS score. MODS score is superior for cardiovascular function compared with SOFA score.