摘要
目的探讨基于红细胞分布宽度的肺炎临床评分(RPCS)对收住重症监护病房(ICU)的社区获得性肺炎(CAP)预后的判断价值,并与CURB-65评分、PSI评分比较。方法回顾性分析2017年10月至2019年8月在黄山市人民医院ICU住院的CAP患者的临床资料。根据患者在ICU的转归分为死亡组(n=30例)与好转组(n=74),比较两组患者3种评分和其他指标的差异。用受试者工作特征曲线下面积评价3种评分对CAP入住ICU预后的判断力。结果104例患者被纳入最后的分析,好转组74例,死亡组30例,病死率为28.85%。CURB-65评分、PSI评分和RPCS评分的ROC曲线下面积分别是0.652(95%CI:0.533~0.770,P=0.016)、0.798(95%CI:0.709~0.886,P<0.001)、0.858(95%CI:0.788~0.928,P<0.001)。PSI和RPCS的ROC曲线下面积均大于CURB-65评分,差异有统计学意义(Z=1.981,P=0.048;Z=3.167,P=0.002),RPCS评分和PSI评分的ROC曲线下面积比较,差异无统计学意义(Z=1.062,P=0.288)。结论RPCS对入住ICU的CAP患者预后有较好的判断价值,与PSI评分相当,优于CURB-65评分,且评分简便,值得在临床中推广使用。
Objective To evaluate the prognostic effects of RDW based pneumonia clinical score in patients admitted in ICU with community acquired pneumonia,compared with CURB-65 score and pneumonia severity index(PSI)score.Methods The clinical characteristics of patients admitted to People’s Hospital of Huangshan from October 2017 to August 2019 with a diagnosis of community acquired pneumonia were retrospectively analyzed.The patients were assigned to the death group(n=30)and the survival group(n=74).Three different scores were compared with other variables.The areas under the receiver operating characteristic curve were applied to evaluate three scores prognosis values in community-acquired pneumonia of ICU.Results Among 104 patients,30 patients were finally assigned to the death group and 74 patients to the survival group.The mortality was 28.85%.The area under the ROC of CURB-65 score,PSI score and RPCS score was respectively 0.652(95%CI:0.533~0.770,P=0.016),0.798(95%CI:0.709~0.886,P<0.001),0.858(95%CI:0.788~0.928,P<0.001).The area under the ROC of PSI score and RPCS score was higher than that of CURB-65 score(Z=1.981,P=0.048;Z=3.167,P=0.002).The area under the ROC curve of RPCS score and PSI score showed no statistically significant difference(Z=1.062,P=0.288).Conclusion RPCS score has greater prognostic value in patients with community acquired pneumonia,which is equal to PSI score and better than CURB-65 score.The score is simple and worthy of clinical popularization and application.
作者
谢立德
孟珊珊
洪曦菲
张牧城
郑绍鹏
XIE Lide;MEN Shanshan;HONG Xifei;ZHANG Mucheng;ZHENG Shaopeng(Department of Critical Care Medicine,People’s Hospital of Huangshan,Wannan Medical College,Huangshan 245000,China;Department of Critical Care Medicine,Zhongda Hospital,Southeast University,Nanjing 210000,China)
出处
《安徽医学》
2022年第1期28-32,共5页
Anhui Medical Journal
基金
江苏省自然科学基金(项目编号:BK20200367)
黄山市第五批市“特支计划”创新领军人才科研基金项目(项目编号:黄人才办[2020]3号)。