老年多器官功能不全综合征早期预测评分系统的前瞻性评估

Evaluation of the early prediction score system for multiple organ dysfunction syndrome in the elderly

目的 前瞻性评估老年多器官功能不全综合征（MODSE）早期预测评分系统在老年肺部感染并发MODSE高危人群筛查和老年人肺部感染后MODSE早期预测方面的价值.方法 采用自主设计的MODSE早期预测评分系统对2007年6月至2009年6月住院的60岁以上肺部感染患者316例进行评分,根据评分结果将患者分为高危组和非高危组,随访观察比较两组MODSE的发病率;绘制MODSE早期预测评分受试者工作特征（ROC）曲线,计算ROC曲线下面积及MODSE早期预测评分系统的敏感度和特异度.结果 MODSE高危组的MODSE发病率显著高于非高危组（χ2=87.569,P＜0.01）;ROC曲线下面积为0.864,面积的95%可信区间为0.820～0.907（P＜0.01）;MODSE早期预测评分系统的敏感度和特异度分别为84.2%和72.1%.结论 MODSE早期预测评分系统对筛查老年肺部感染并发MODSE的高危人群、早期预测老年人肺部感染后MODSE的发病具有很大价值,可作为老年肺部感染并发MODSE高危人群的筛查工具.

Objective To evaluate the early prediction score system for multiple organ dysfunction syndrome in the elderly （MODSE） induced by pulmonary infection. Methods A total of 316 patients with pulmonary infection aged over 60 were admitted from 2007 Jun to 2009 Jun. All patients were scored by the early prediction score system for MODSE and then classified as high-risk group and non high-risk group. χ2 test was used to analyze the difference in morbidity of MODSE between high-risk group and non high-risk group. Receiver operating characteristic （ROC） curve was drawn, and the area under the curve, sensitivity and specificity was calculated. Results The morbidity of MODSE in high-risk group was higher than that in non high-risk group（χ2=87.569,P〈0.01）.The area under the ROC curve was 0.864（P〈0.01）.The sensitivity and specificity of the early prediction score system of MODSE were 84.2% and 72. 1%, respectively. Conclusion The early prediction score system for MODSE can be used to predict MODSE induced by pulmonary infection and to screen for the high risk population.