急诊脓毒症严重程度评分对ICU脓毒症患者预后的预测价值

Emergency department severity of sepsis score in evaluating prognosis of septic patients

目的探讨急诊脓毒症严重程度评分(EDSSS)对ICU脓毒症患者预后的预测价值。方法回顾皖南医学院附属黄山市人民医院2018年1月至2019年7月收治符合脓毒症3.0标准的脓毒症患者临床资料,根据转归将患者分为死亡组和存活组,分别计算两组患者的EDSSS和急性生理学与慢性健康评估Ⅱ(APACHEⅡ)评分,进行比较分析。结果共纳入109例患者,存活组患者66例(60.55%),死亡组43例(39.45%)。APACHEⅡ评分和EDSSS预测死亡风险的诊断截点分别为20.5分和5.5分,Youden指数分别为0.233和0.401,灵敏度分别为0.581和0.628,特异度分别为0.652和0.773,AUC分别是0.691(95%CI:0.591~0.791,P=0.001)和0.780(95%CI:0.692~0.869,P=0.000)。结论EDSSS对脓毒症患者的死亡有较好的预测价值,优于APACHEⅡ评分。

Objective To explore the value of emergency department severity of sepsis score(EDSSS)in evaluating the prognosis of septic patients.and compare it with.Methods One hundred and nine patients who met Sepsis 3.0 diagnostic criteria admitted to Department of Critical Care Medicine from January 2018 to July 2019 were retrospectively analyzed.There were 43 cases in fatal group and 66 cases in survival group.The EDSSS and acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores of the two groups were calculated and compared.Results The cut-off scores of APACHEⅡscore and EDSSS for fatal prognosis was 20.5 and 5.5,Yoden index was 0.233 and 0.401,sensitivity was 0.581 and 0.628,specificity was 0.652 and 0.773,and the area under the ROC was 0.691(95%CI:0.591~0.791,P=0.001)and 0.780(95%CI:0.692~0.869,P=0.000),respectively.Conclusion EDSSS had a better value to predict the outcome of septic patients than APACHEⅡscore.