SOFA评分对急诊室无创正压通气治疗患者的预后评估价值

Predicted Value of SOFA Score to Assess the Outcome on Patients Treated by Non-invasive Positive Pressure Ventilation in Emergency Department

目的:评估应用序贯性器官功能衰竭评价(SOFA)评分对急诊室使用无创正压通气(NPPV)治疗的患者进行病情预后的价值。方法:回顾我科2010年1月-2012年10月使用NPPV患者104例的临床资料,记录入院24 h内的SOFA评分,以死亡或需无创转换气管插管者为预后不良组(A组,n=54),成功脱机者为预后良好组(B组,n=50),利用ROC曲线评价SOFA评分对无创正压通气患者的预后评估价值。结果:A组SOFA评分(8.06±2.96)和中位数(四分位数间距)[8(6-10)]明显高于B组的SOFA评分(4.60±1.94)和中位数(四分位数间距)[4(3-6)](P<0.05)。SOFA评分对预后判断ROC曲线下面积为0.810(P<0.001),Cutoff值为>5,敏感度为83.33%((70.7-92.1),特异度为60.8%(53.3-80.5)。阳性预测值73.8%(60.9-84.2),阴性预测值79.1%(64.0-90.0)。结论 :SOFA评分对急诊室使用NPPV治疗患者的预后有较好预测价值。

Objective： To evaluate the predicted value of sequential organ failure assessment （SPFA）score to assess the outcome on patients treated by non-invasive positive pressure ventilation （NPPV） in Emergency Department. Methods： A retrospective analysis was made in 104 cases treated by of NPPV in Emergency Department from Jan 2010 to Oct 2012. The cases were classified as bad outcome group （group A,n=54） if death or transfer to invasive ventilation; those who success to off ventilation were classified as good outcome group （group B, n=50）. SOFA score was obtained within the first 24 h following admission. The predicted value of SOFA score to assess the outcome of patients was analysis by the receiver operating character curve. Results：The SOFA score （8.06±2.96）and Median （IQR） [8（6-10）] in group A were significantly higher than those in group B （4.60±1.94） and [4（3-6）], （P〈0.05）. Area under curve of ROC curve was 0.810 （P〈0.001）,cutoff was 〉5 with sensitivity 83.33% （70.7-92.1）,specificity 60.8% （53.3-80.5）.The positive predicting value was73.8%（60.9-84.2） ,the negative predicting value was 79.1% （64.0-90.0）. Conclusions：SOFA score could be well used to predict the outcome on cases treated by NPPV in Emergency Department.