Elixhauser合并症指数可评估重症吸入性肺炎患者的预后

Elixhauser comorbidities index may evaluate the prognosis of critically ill patients with aspiration pneumonia

目的:探讨Elixhauser合并症指数(ECI)与重症吸入性肺炎患者院内死亡之间的关系,并评价其对吸入性肺炎患者院内死亡的预测价值。方法:运用T-SQL语言从美国重症医学数据库(MIMIC-Ⅲ)中提取患者人口学特征、合并症等临床资料,运用单因素分析、多因素logistic回归分析和分层分析评价ECI与重症吸入性肺炎患者院内死亡之间的关系,通过受试者工作特性(ROC)曲线评估ECI预测院内死亡的临床价值。结果:共纳入402例患者,其中存活患者330例,死亡患者72例。单因素分析结果提示年龄、机械通气、ECI和CRUB-65评分与患者的院内死亡相关(P均<0.05);多因素logistic回归分析提示ECI≥21分是院内死亡的独立危险因素[OR值(95%CI):1.98(1.14,3.45),P=0.0154];ECI预测院内死亡的ROC曲线下面积为0.6169(95%CI:0.5424,0.6913),与CRUB-65评分相比无显著差异。结论:ECI≥21分是重症吸入性肺炎患者院内死亡的独立危险因素,可用于初步评估患者的预后。

Objective:To investigate the relationship between Elixhauser comorbidities index(ECI)and in-hospital mortality of critically ill patients with aspiration pneumonia and to investigate the predictive value of the ECI for the in-hospital mortality of aspiration pneumonia patients.Methods:We extracted the clinical data of demographic characteristics and complications in patients with aspiration pneumonia from the Medical Information Mart for Intensive Care III(MIMIC III)using Structured Query Language(SQL).Univariate and multivariate logistic regression models and the subgroup analysis were used to evaluate the association between ECI and the in-hospital mortality.The ROC curve was used to assess the clinical value of the ECI in predicting in-hospital mortality.Results:A total of 402 patients were included in the analyses,with 330 survivors and 72 deaths in hospital.Univariate logistic regression indicated that age,mechanical ventilation,ECI and CRUB-65 score were associated with in-hospital mortality(P<0.05).Multivariate logistic regression indicated that the ECI≥21 was an independent risk factor for in-hospital mortality[OR(95%CI):1.98(1.14,3.45);P=0.0154].The area under the ROC curve for ECI predicting in-hospital mortality was 0.6169(95%CI 0.5424,0.6913),which was not significantly different from the crub-65 score.Conclusion:ECI≥21 is an independent risk factor for in-hospital mortality in critically ill patients with aspiration pneumonia,which can be used to preliminarily evaluate the prognosis of patients.