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目的研究危重病评分系统对急诊内科危重病人预后预测的对比结果。方法选取2005年10月～2006年8月的急诊内科危重病人103例,应用 APACHEIⅡ、APACHEⅢ、SAPSⅡ、MPM_0、MPM 24评分系统计算入急诊抢救室当时及24 h 最差值时分值及预测病死率,分析比较入急诊抢救室当时及24 h 最差值时对预测预后的差异有无统计学意义。结果各种评分系统在人院当时及24 h 最差值时取值对预后预测均无明显差异(P>0.05)。各种评分系统的分值和预计死亡率在存活组和死亡组之间差异显著,且入院时分数越高,病情越重,死亡率越高。结论各种评分系统均可用于预测急诊内科危重病人的预后。选取入院当时的参数进行评分,对预测预后无明显影响,但仍以入院时 APACHEⅡ评分系统为首选。
Objective To compare the predictive value of critical illness scoring system in prognosis of critically ill patients in emergency department. Methods A total of 103 critically ill patients in emergency department from October 2005 to August 2006 were enrolled in this study. The APACHEIⅡ, APACHEⅢ, SAPSⅡ, MPM_0 and MPM24 scoring systems were used to calculate the hourly scores of emergency rooms and 24-hour worst case scores Rate, analysis and comparison into the emergent emergency room at the time and 24 h worst value of the prognosis of the difference was statistically significant. Results The scores of various scoring systems at the time of hospital admission and the worst value of 24 h had no significant difference in prognosis (P> 0.05). The score and expected mortality of various scoring systems were significantly different between survivors and deaths, and the higher the score at admission, the heavier the illness was, the higher the mortality was. Conclusions Various scoring systems can be used to predict the prognosis of critically ill patients in emergency medicine. At the time of admission, the parameters were selected for evaluation, which had no significant effect on the prediction of prognosis. However, APACHEⅡscore system was the first choice on admission.