EHSS评分系统对劳力性热射病患者预后的评估价值

Prognostic Value of EHSS Scoring System in Patients with Exertional Heat Stroke

目的评估劳力性热射病评分(EHSS)系统对劳力性热射病(EHS)患者预后的评估价值。方法选取2020年6月-2022年8月绵阳市中心医院重症医学科收治的89例劳力型热射病患者为研究对象,按预后情况分为存活组(62例)及死亡组(27例)。采集患者入院24 h内的EHSS评分系统参数,包括体温、肝肾功能、凝血功能、急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)和序贯器官衰竭评分(SOFA),绘制受试者工作特征(ROC)曲线,分析上述3项评分对患者预后的评估价值。结果两组性别、年龄、核心体温比较,差异无统计学意义(P>0.05);单因素分析显示,存活组与死亡组入院24 h内EHSS评分系统各参数比较,差异均有统计学意义(P<0.05);存活组EHSS、APACHEⅡ、SOFA评分低于死亡组,差异有统计学意义(P<0.05);ROC曲线显示,EHSS评分曲线下面积(AUC)为0.997,大于APACHEⅡ评分(0.911)和SOFA评分(0.881),其诊断效率高于其他2种评分,EHSS评分评估患者预后的敏感性和特异性均高于APACHEⅡ和SOFA评分,差异有统计学意义(P<0.05)。结论EHSS、APACHEⅡ和SOFA评分均能较好的预测劳力性热射病患者的预后,其中EHSS评分更为准确。

Objective To evaluate the prognostic value of the exertional heat stroke score(EHSS)system in patients with exertional heat stroke(EHS).Methods A total of 89 patients with exertional heat stroke admitted to the Intensive Care Unit of Mianyang Central Hospital from June 2020 to August 2022 were selected as the research objects.According to the prognosis,they were divided into survival group(62 patients)and death group(27 patients).The parameters of EHSS scoring system within 24 h after admission were collected,including body temperature,liver and kidney function,coagulation function,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and sequential organ failure assessment(SOFA)score.The receiver operating characteristic(ROC)curve was drawn to analyze the prognostic value of the above three scores.Results There was no significant difference in gender,age and core body temperature between the two groups(P>0.05).Univariate analysis showed that there were significant differences in the parameters of EHSS scoring system between the survival group and the death group within 24 hours after admission(P<0.05).The scores of EHSS,APACHEⅡand SOFA in the survival group were lower than those in the death group,and the differences were statistically significant(P<0.05).ROC curve showed that the area under the curve(AUC)of EHSS score was 0.997,which was higher than that of APACHEⅡscore(0.911)and SOFA score(0.881),and its diagnostic efficiency was higher than that of the other two scores.The sensitivity and specificity of EHSS score in evaluating the prognosis of patients were higher than those of APACHEⅡscore and SOFA score,and the differences were statistically significant(P<0.05).Conclusion EHSS,APACHEⅡand SOFA scores can better predict the prognosis of patients with exertional heat stroke,and the EHSS scoring system is more accurate.