P-POSSUM评分系统对外科重症患者术后不良事件的预测价值

Predictive Value of P-POSUUM Scoring System to Adverse Events after Operation in Surgical Critically Ill Patients

目的:探讨改良POSSUM评分系统对外科重症患者术后不良事件的预测价值。方法:采用回顾性研究方法,对2016年1月至2017年1月入住重症医学科的79例外科重症患者进行分析,按照术后28天预后分为预后良好组(n=62)和预后不良组(n=17)。分析两组改良POSUUM评分系统、CCI、APACHE Ⅱ评分。结果:预后良好组改良POSUUM评分系统、CCI、APACHE Ⅱ评分均显著低于预后不良组(P<0.05)。P-PSOUUM评分系统、CCI、APACHE Ⅱ评分ROC曲线下面积分别为0.859(95%CI:0.778-0.939)、0.806(95%CI:0.675-0.938)、0.818(95%CI:0.715-0.921)。P-PSOUUM评分系统和APACHE Ⅱ评分分别取35.5和11.5为最佳临界值时,序列试验的诊断效能优于平行试验。结论:P-PSOUUM评分系统和APACHE Ⅱ评分进行序列试验可以提高预测外科重症患者术后不良事件的特异度。

Objective:To investigate predictive value of P-POSUUM scoring system to adverse events after operation in surgical critically ill patients. Methods:A retrospective study was conducted. 79 surgical critically ill patients were analyzed from Jua 2016 to Jua 2017. According to 28-day prognosis,79 patients were divided into good prognosis group(n=62)and bad prognosis group(n=17). P-POSUUM,CCI,APACHE Ⅱ score were analyzed. Results:P-POSUUM scoring system,CCI,APACHE Ⅱ score in good prognosis group were significantly lower than those in bad prognosis group(P<0.05). Area under ROC of P-POSUUM scoring system,CCI,APACHE Ⅱ score were 0.859(95%CI:0.778-0.939)、0.806(95%CI:0.675-0.938)、0.818(95%CI:0.715-0.921). With the optimal cut-off value of PPOSUUM scoring system and APACHE Ⅱ score,serial test was superior to parallel test. Conclusion:Serial test could improve diagnostic specificity to adverse events after operation in surgical critically ill patients.