MODS评分和APACHE Ⅱ评分对多脏器功能障碍综合征患者预后评价的比较

The comparison of prognosis evaluation in MODS patients using MODS and APACHE Ⅱ score in emergency department

目的:比较MODS评分(Marshall标准)和APACHEⅡ评分在评估多脏器功能障碍综合征患者的预后评价。方法:分析急诊科监护病房273例患者的住院资料,并进行MODS评分和APACHEⅡ评分,根据其当次入院后病死率,比较两种评分与患者预后的相关性,通过ROC曲线下面积比较两种评分的准确性。结果:MODS评分和APACHEⅡ评分分值越高,死亡危险率越高,各分组间病死率比较差异均有统计学意义(P<0.01);MODS评分、APACHEⅡ评分的ROC曲线下面积分别为0.765和0.802,MODS和APACHEⅡ评分比较ROC曲线下面积差异有统计学意义(P<0.01)。结论:两种评分均能对多脏器功能障碍综合征患者的预后进行较为准确的评估,APACHEⅡ评分优于MODS评分。但从急诊科快速评估病情的角度考虑,MODS评分获得简便快捷,更符合急诊科的需求。

Objective：To study the effects of MODS and APACHE II score in prognosis evaluation of MODS patients in etnergency department. Method：Data of 273 patients was collected. The MODS score and APACHE II score were calculated in 24 bours. The mortalily of patients in different score was analyzed to estimate the dependability of them via arca under the ROC curve. Result： The mortality rate increased with scores increasing. The mo tility difference between each group had statistical significance （P〈0. 001）. The area under ROC curve of MODS and APACHE II score was 0. 765 and 0. 802. The area under the ROC curve of MODS and APACHE II score had significant difference （P〈0. 01）. Conclusion： Both score were useful predictors of outcomes in severe patients. APACHE II score is better than MODS score. However,MODS score may be more suitable for emergency patient because of convenience and shortcut. Key words MODS;MODS score;APACHE II score;ROC curve