骨科老年患者手术风险评分系统预测624例患者的应用价值

Application value of operation risk scoring system for senile patient in predicting 624 senile cases

目的探讨骨科老年患者手术风险评分系统(ORSSSP)的预测价值。方法应用ORSSSP预测2008年1月至2011年12月该院收治的骨折住院老年患者624例的手术死亡率和并发症率,比较预测值与观察值的差异。结果预测23例死亡,观察3例死亡,预测值高于观察值,差异有统计学意义(χ2=20.821,P=0.013)。ROC曲线下面积为为0.711(标准误0.025,95%可信区间:0.661～0.761),该评分系统预测价值中等。结论 ORSSSP评分系统高估了骨科老年患者术后并发症率及死亡率,需进一步改良。

Objective To investigate the predicting value of the orthopedic operation risk scoring system for senile patient（ORSSSP）applied in senile orthopedic patients.Methods 624 senile orthopedic cases were collected in the orthopedic department of this hospital from January 2008 to December 2011.ORSSSP was adopted to predict the operation mortality and the complication rate.The differences between predicted values and observation values were compared.Results 23 cases of death were predicted and 3 cases of death were observed.The predicted value was higher than that of observation value with statistical difference（χ2=20.821,P=0.013）.The area under the ROC curve was 0.711（SE 0.025,95%CI：0.661-0.761）,the predict value of this scoring system was secondary.Conclusion ORSSSP overestimates the postoperative complication rate and mortality,and needs to be further modified.