APACHEⅡ评分和SOFA评分对鲍曼不动杆菌感染患者预后的预测价值比较

Comparison of the predictive value of APACHEⅡ score and SOFA score on the prognosis of patients with acinetobacter baumannii infection

目的:比较急性生理学与慢性健康状况评分(APACHEⅡ)和序贯器官衰竭估计评分(SOFA)对鲍曼不动杆菌感染预后的预测价值。方法:回顾性分析1 359例鲍曼不动杆菌感染患者的临床资料,计算患者入院24 h内和确诊感染鲍曼不动杆菌的APACHEⅡ、SOFA评分,比较2种评分预测鲍曼不动杆菌感染患者特征曲线(ROC)的曲线下面积(AUC),及其灵敏度和特异度。结果:1 359例鲍曼不动杆菌感染病例中,死亡例数为399例,病死率为29.4%,多重耐药例数为742例,占54.6%。病死组APACHEⅡ评分和SOFA评分均高于存活组,有显著性差异(P<0.01),确诊时APACHEⅡ、SOFA评分预测死亡的AUC分别为0.913,0.904。结论:确诊时APACHEⅡ评分和SOFA评分均可用于对鲍曼不动杆菌感染患者预后结局的预测。

OBJECTIVE To compare the prognostic value of Acute Physiology and Chronic Health Evaluation(APACHEⅡ)and Sequential Organ Failure Estimation(SOFA)in patients with Acinetobacter baumannii infection.METHODS The clinical data of 1 359 patients with Acinetobacter baumannii infection were retrospectively analyzed.The APACHEⅱand SOFA scores were calculated within 24 h after admission and after diagnosis of Acinetobacter baumannii infection.RESULTS Among 1 359 cases of Acinetobacter baumannii infection,399 cases died,the fatality rate was 29.4%,and 742 cases(54.6%)were multidrug resistant.The APACHEⅡscore and SOFA score in the death group were higher than those in the survival group,with significant differences(P<0.01).The AUC of APACHEⅡand SOFA score in predicting death at the time of diagnosis was 0.913 and 0.904,respectively.CONCLUSION APACHEⅡscore and SOFA score at the time of diagnosis can be used to predict the outcome of patients with A.baumannii infection.