急诊ROX指数对自发性脑出血患者短期不良预后的评估价值

Evaluation value of emergency ROX index for short-term poor prognosis in patients withspontaneous cerebral hemorrhage

目的探讨ROX指数对急诊自发性脑出血患者短期不良预后的评估价值,为急诊医务人员早期识别危重患者提供依据。方法回顾性分析2020年1月1日至—2022年12月31日在皖南医学院第二附属医院急诊抢救室的159例自发性脑出血患者临床资料,按照急诊是否气管插管入住ICU分为预后良好组与预后不良组。根据患者呼吸参数计算ROX指数,分析其对自发性脑出血患者预后的评估价值。结果预后不良组的收缩压、白细胞、MEWS评分均高于预后良好组,SpO_(2)、GCS评分、ROX指数均低于预后良好组,差异有显著性(P<0.05)。单因素分析显示,ROX指数、SpO_(2)、MEWS评分可较好预测自发性脑出血患者短期不良预后(P<0.05)。ROC曲线分析表明,ROX指数(AUC:0.853,95%CI:0.792~0.914,P<0.001)预测自发性脑出血患者短期不良预后的效能优于SpO_(2)(AUC:0.734,95%2CI:0.634~0.833,P<0.001)及MEWS评分(AUC:0.760,95%CI:0.673~0.847,P<0.001),ROX指数最佳截断值为13.15,敏感度为66.90%,特异度为88.60%。结论入院时低ROX指数与自发性脑出血患者的机械通气入住ICU高风险相关,可用于预测自发性脑出血患者的短期不良预后。

Objective To investigate the evaluation value of ROX index for short-term poor prognosis in patients withemergency spontaneous cerebral hemorrhage,to provide evidence support for emergency medical staff to identify critical patients in early stage.Methods:The clinical data of 159 patients with spontaneous cerebral hemorrhage in the emergency room of the Second Affiliated Hospital of Wannan Medical College from January 1,2020 to December 31,2022 were retrospectively analyzed in the study.Patients were divided into good prognosis group and poor prognosis group according to whether they were admitted to ICU with accepting endotracheal intubation in emergency.The ROX index was calculated according to the respiratory data of patients to analyze its value in prognosis evaluation of patients with spontaneous intracerebral hemorrhage.Results:ROX index,SpO_(2) and MEWS score confirmed to predict short term poor prognosis of patients with spontaneous intracerebral hemorrhage(P<0.05).ROC curve analysis showed that ROX index(AUC:0.853,95%CI:0.792-0.914,P<0.001)had better predictive value than SpO_(2)(AUC:0.734,95%CI:0.634-0.833,P<0.001)and MEWS score(AUC:0.760,95%CI:0.673-0.847,P<0.001),the optimal cut-off value of ROX index was 13.15,sensitivity was 66.90%,specificity was 88.60%.Conclusion:Low ROX index which measured just been patients admitted to hospital was associated with high risk of mechanical ventilation admission to ICU in patients with spontaneous cerebral hemorrhage,it can be used to predict short-term poor prognosis in patients with spontaneous cerebral hemorrhage.