慢性阻塞性肺疾病急性加重期患者短期预后预测模型的建立

Establishment of short-term prognostic rules for patients with acute exacerbation of chronic obstructive pulmonary disease

目的建立适合于急诊科医护人员使用的评估COPD急性加重期患者病情危重程度的预测规则,以便更好地辨识危重患者并及时为其提供治疗、护理干预。方法采用方便取样的方法,收集2017年3月—2018年1月进入急诊科的符合纳入、排除标准的COPD急性加重期患者信息,将患者分为病情平稳组和病情危重组,对两组患者资料进行单因素分析、Logistic回归分析,从而得出模型并对其进行简化。结果本研究共纳入142例患者,国家早期预警评分、Charlson合并症指数、年龄这3个因素进入模型。模型对患者短期预后预测的ROC曲线下面积为0.903[95%CI(0.845,0.960)],进一步简化评分规则,其ROC曲线下面积为0.900。结论本研究所得预测模型可以科学、有效地对COPD急性加重期患者的预后进行预测,且所有指标简单易得,可快速获取,为急诊临床护理工作带来了便利。

Objective To establish a predictive model suitable for emergency medical staff to evaluate the severity of patients with acute exacerbation of chronic obstructive pulmonary disease (AEC0PD), so as to better identify critical patients and provide timely treatment and nursing intervention. Methods The patients with AEC0PD who visited the emergency department from March 2017 to January 2018 were enrolled using convenience sampling method and divided into stable group and critical group. The data of the two groups were analyzed by univariate analysis and logistic regression analysis to establish the model and simplify it. Results A total of 142 patients were included in the study. Three factors including NEWS,CCI and age,entered the model. The AUC predicted by the model was 0.903[95%CI(0.845,0.960)]. With further simplifying the scoring rules,then AUC was 0.900. Conclusion The predictive model in this study can better predict the prognosis of patients with AEC0PD, and all the indicators are simple and easy to obtain, which is convenient for emergency clinical nursing to use.