|
| 肺损伤预测评分对重症患者急性呼吸衰竭风险的预测价值 |
| Value of lung injury prediction score in predicting risk of acute respiratory failure in severe patients |
| 投稿时间：2019-02-28 |
| DOI：10.3969/j.issn.1000-0399.2019.09.003 |
| 中文关键词: 肺损伤预测评分 急性呼吸衰竭 受试者工作特征曲线 ICU病死率 |
| 英文关键词: Lung injury prediction score Acute respiratory failure Receiver operating characteristic ICU mortality |
| 基金项目:国家自然科学基金项目（项目编号：81100053） |
|
| 摘要点击次数: 2085 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的 探讨肺损伤预测评分（LIPS）对重症患者急性呼吸衰竭风险的预测价值。方法 选择2016年11月至2018年12月安徽省阜阳市人民医院63例收入ICU时未出现急性呼吸衰竭的患者，依据入ICU后患者是否发生急性呼吸衰竭分为急性呼吸衰竭组40例与非急性呼吸衰竭组23例。采用多因素logistic回归模型筛选发生急性呼吸衰竭的影响因素，受试者工作特征曲线（ROC曲线）评价不同指标的预测价值。结果 多因素logistic回归分析显示，LIPS、快速序贯性脏器功能衰竭评分（qSOFA）和急性生理和慢性健康评分（APACHEⅡ）均可作为急性呼吸衰竭的预测评分指标，其中以LIPS的OR值最高。LIPS的ROC曲线下面积（AUC）为0.754（P<0.001），LIPS的最佳截断点为4分，其灵敏度为83.24%，特异度为64.21%。LIPS≥4分组患者急性呼吸衰竭发生率、住ICU病死率、住院病死率等均高于LIPS<4分组，差异均有统计学意义（P<0.05）。结论 LIPS有助于早期识别发生急性呼吸衰竭高风险重症患者，从而降低重症患者机械通气使用率和ICU病死率。 |
| 英文摘要: |
| Objective To investigate the predictive value of the lung injury prediction score (LIPS) for the risk of acute respiratory failure (ARF) in critically ill patients. Methods Patients admitted to the ICU of Fuyang People's Hospital of Anhui Province from November 2016 to December 2018 were selected, then a total of 63 patients without ARF occurred during admission. According to whether ARF occurred after admission to ICU, the patients were divided into 40 cases of ARF group and 23 cases of non-ARF group. Multivariate logistic regression model was used to screen the influencing factors of ARF, and the receiver operating characteristic (ROC curve) was used to evaluate the predictive value of different indicators. Results Multivariate stepwise logistic regression analysis showed that LIPS, quick Sequential Organ Failure Assessment (qSOFA) and Acute Physiological And Chronic Health Evaluation Ⅱ (APACHEⅡ) could all be used as predictive scoring indicators for acute respiratory failure, among which OR of LIPS was the highest. The area under LIPS rating ROC curve (AUC) was 0.754 (P<0.001), and the optimum cut-off point for LIPS score was 4 points, with a sensitivity of 83.24% and specificity of 64.21%. The patients in LIPS ≥ 4 group were significantly higher in mortality in ICU, mortality in hospital, incidence of ARF than those in LIPS<4 group, all with statistically significant differences (P<0.05). Conclusions LIPS has a good predictive value for the risk of ARF in critically ill patients. This score enables early identification of patients with a high risk of ARF, which may reduce the use of mechanical ventilation and the mortality rate of ICU patients. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
