神経科の重症治療室での大血管閉塞性急性脳卒中患者の28日間の死亡率の予測
Wenjing Qin1, Chengcheng Xiao2, Jing Yang1
1Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Frontiers in neurology
|September 5, 2025
まとめ
急性生理学的および慢性的な健康評価システムII (APACHE II) のスコアは,大血管閉塞性脳卒中 (LVOS) 患者の内血管治療 (EVT) 後の28日間の死亡率を効果的に予測します. APACHE IIスコアは16. 5以上で,死亡リスクが著しく高まっていることを示します.
科学分野:
- 神経学
- クリティカル ケア 医療
- 心血管疾患
背景:
- 既定の予後スコアであるNIHSS,GCS,mRSは脳卒中のために存在する.
- NICUでのEVT後のLVOS患者の死亡率に対するAPACHE IIの予測値はよく定義されていません.
研究 の 目的:
- 大血管閉塞性脳卒中 (LVOS) の患者で内血管治療 (EVT) を受け,神経重症治療室 (NICU) に入院した患者の28日間の死亡率を予測するAPACHE IIスコアの有効性を評価する.
主な方法:
- EVTを受けた93人の急性前頭循環 LVOS患者による遡及コホート研究.
- APACHE IIのスコアを生存者と28日の生存者との比較
- 受信機操作特性 (ROC) 曲線解析と多変数ロジスティック回帰により,予測性能を評価し,独立した予測要因を特定する.
主要な成果:
- 死亡グループでは,生存グループと比較してAPACHE IIスコアが著しく高かった (21. 84 ± 4. 10).
- ROC分析では,最適な値である16. 5 (感度94. 7%,特異性75. 7%) との優れた差別が示されました.
- APACHE IIスコア (OR 1. 239) と脳ヘルニア (OR 11. 404) は死亡率の独立した予測因子として特定されました.
結論:
- APACHE IIスコアは,EVT後24時間以内に評価され,新生児集中治療室での急性前循環性LVOS患者の28日間の死亡率の信頼できる予測指標である.
- APACHE IIスコアの値16. 5は,死亡リスクを効果的に分層化し,死亡率は≥16. 5の患者で50%で,スコアが<16. 5の患者では1. 8%であった.
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