CPIS评分与ASS评分对重型颅脑损伤继发感染的评估价值

Value of CPIS score and ASS score in severe craniocerebral injury secondary infection

目的探讨肺部感染评分(clinical pulmonary infection score,CPIS)与全身炎症反应综合征修正评分(adjus-ted score of systemic inflammatory response syndrome,ASS)对重型颅脑损伤继发感染的评估价值。方法对103例符合纳入标准的重型颅脑损伤继发感染病例,运用CPIS评分与ASS评分系统,以住院内的存活情况、住ICU时间、住院时间和感染控制时间作为预后的结局终点评价指标,并以住院内的存活情况作为首要结局终点评价指标进行统计学分析。并根据受试者特征曲线(receiver operating characteristic curve,ROC)比较各评分系统的预测能力。结果死亡组CPIS评分(Z=3.44,P<0.01)和ASS评分(t=6.26,P<0.01)均明显高于存活组;生存患者ASS评分与住ICU时间、住院时间、感染控制时间呈正相关(r分别为0.695、0.725、0.707,P<0.01),根据ROC曲线下的面积(area under curve,AUC)比较CPIS评分和ASS评分,结果显示2种评分预测生存均有价值(AUC分别为0.835、0.836)。结论 CPIS评分与ASS评分对重型颅脑损伤继发感染有评估价值,可以对重型颅脑损伤继发感染进行量化评估,提高治疗的科学性和准确性。

Objective To investigate the value of clinical pulmonary infection score （ CPIS score） and the adjusted score of systemic inflammatory response syndrome （ASS score ） in severe eraniocerebral injury secondary infection. Methods A total of 103 patients with severely craniocerebral injury who were admitted in our department from January 2009 to January 2011 were recruited in this study. CPIS score and ASS score were used to evaluate the patients. The indexes of endpoints for prognosis were ICU stay time, hospitalization time and infection control time. Hospital mortality was the primary outcome endpoint. Receiver operating characteris- tic curve（ROC） was plotted to determine the predictive value of the 2 scale system. Results The dead group had higher CPIS score （Z = 3. 444, P 〈 0.01 ） and ASS score （t = 6.26, P 〈 0.01 ） than the survivors. The ASS score of the survivors was positively correlated with the ICU stay time, hospitalization time and the infection control time （r =0. 695, P 〈 0.01 ; r = 0. 725, P 〈 0.01 ; r = 0. 707, P 〈 0. 01 ）. The area under curve （AUC） was 0. 835 for CPIS score, and 0.836 for ASS score, indicating that both of the scores had a good cali- bration to predict mortality in the patients. Conclusion Both CPIS score and ASS score have a good calibra- tion for predicting mortality in patients of severe craniocerebral injury secondary infection. The scores can quantitatively evaluate these patients, and are of great value to carry out scientific and accurate treatment.