新型危重症评分量表对患者转入重症监护室及死亡的预测价值

Predictive value of new type critical illness score scale for patients transferred to intensive care units and death

目的创建基于logistic回归预测模型的新型危重症评分量表,评价量表对患者转入重症监护室(ICU)及死亡的预测价值。方法回顾性收集2022年10月至2023年10月该院HIS系统1000例患者的临床资料,基于既往研究创建的logistic回归预测ICU转入率模型创建新型危重症评分量表。分别以改良早期预警评分(MEWS)和急性生理学与慢性健康状况评分系统Ⅱ(APCHEⅡ)评分为参考,采用受试者工作特征(ROC)曲线和曲线下面积(AUC)评价新型危重症评分量表对患者转入ICU及死亡的预测价值。结果患者ICU转入率为29.8%,死亡率为8.10%。转入ICU或死亡患者的新型危重症评分量表、MEWS和APCHEⅡ评分明显高于未转入ICU或死亡患者(P<0.05)。新型危重症评分量表、MEWS和APCHEⅡ评分对转入ICU的预测价值均为高等(P<0.05),AUC分别为0.917、0.922、0.934,灵敏度分别为82.26%、84.22%、90.57%,特异度分别为80.36%、73.50%、83.45%,Youden指数分别为62.62%、57.72%、74.02%。新型危重症评分量表、MEWS和APCHEⅡ评分对死亡的预测价值均为高等(P<0.05),AUC分别为0.924、0.914、0.933,灵敏度分别为93.48%、86.38%、84.67%,特异度分别为73.46%、79.38%、88.69%,Youden指数分别为66.94%、65.76%、73.36%。结论新型危重症评分量表对患者转入ICU及死亡的预测价值同传统量表基本一致,可作为新的ICU患者评价工具。

Objective To create the new type critical illness score scale based on logistic regression prediction model,and to evaluate its predictive value for the patient transferring to intensive care unit(ICU)and death.Methods The clinical data in 1000 patients were retrospectively collected from the HIS system of this hospital from October 2022 to October 2023.The new critical illness score scale was created based on the model in predicting the ICU transfer rate created by the previous studies.The modified early warning score(MEWS)and acute physiology and chronic health evaluationⅡ(APCHEⅡ)score served as reference respectively,the predictive value of the new type critical illness score scale for patient transferring to ICU and death was evaluated by using the receiver operating characteristic(ROC)curve and area under curve(AUC).Results The ICU transfer rate of the patients was 29.8%,and the mortality rate was 8.10%.The new type critical illness score scale,MEWS and APCHEⅡscores of the patients who were transferred to ICU or died were significantly higher than those of the patients who were not transferred to ICU or died(P<0.05).The predictive value of the new critical illness scale,MEWS,and APCHEⅡscores for ICU transfer was high(P<0.05).AUC was 0.917,0.922 and 0.934 respectively,the sensitivity was 82.26%,84.22%and 90.57%respectively,the specificity was 80.36%,73.50%and 83.45%respectively and the Youden index was 62.62%,57.72%and 74.02%,respectively.The predictive value of the new type critical illness score scale,MEWS and APCHEⅡscores for the death was high(P<0.05).AUC was 0.924,0.914 and 0.933 respectively,the sensitivity was 93.48%,86.38%and 84.67%respectively,the specificity was 73.46%,79.38%and 88.69%respectively,and the Youden index was 66.94%,65.76%and 73.36%respectively.Conclusion The predictive value of the new type critical illness score scale for the patients transferring to ICU and death is basically consistent with that of the traditional scales,which could serve as a new evaluation tool for ICU patients.