在重症监护室的COVID-19患者中APACHE II分数的死亡率预测值:一个横截面研究
Hamid Reza Mehryar1, Poya Yarahmadi2, Babak C Anzali1
1Department of Emergency Medicine.
Annals of medicine and surgery (2012)
|June 26, 2023
概括
用于预测医院死亡率的急性生理学和慢性健康评估II (APACHE II) 评分,在COVID-19患者中进行了分析. 较高的得分与特定的症状和年龄相关,但它不是该人口中死亡的可靠预测指标.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 健康 结果 研究 研究 结果
背景情况:
- 急性生理学和慢性健康评估II (APACHE II) 评分系统是预测医院死亡率的验证工具.
- 冠状病毒疾病2019 (COVID-19) 构成了重大的公共卫生挑战,需要准确的预后指标.
- 了解COVID-19患者中APACHE II等现有评分系统的实用性对于临床管理至关重要.
研究的目的:
- 在被诊断为COVID-19的患者中确定APACHE II平均得分.
- 调查APACHE II分数与COVID-19患者的临床特征,并发症和结果之间的相关性.
- 在COVID-19的背景下,评估APACHE II评分对医院死亡率的预测值.
主要方法:
- 进行了一项横截面研究,涉及150名由PCR确认的COVID-19患者.
- 收集的数据包括实验室,放射学和临床发现,以及专家计算的APACHE II分数.
- 进行了统计分析,以评估APACHE II分数与各种患者因素之间的关系.
主要成果:
- 平均的APACHE II分数为10.12±6.3.3的时间. 较高的APACHE II分数与咳,喘息,血,胃肠道出血和功能衰竭等症状显著相关.
- 观察到患者年龄和APACHE II评分 (r=0.53,P>0.001) 之间存在显著的直接关系.
- 在男性和女性之间没有发现APACHE II分数的统计学上显著差异. 患有透析病史,甲状腺疾病,高血压,缺血性心脏病和糖尿病患者的APACHE II平均得分较高.
结论:
- 在COVID-19患者中,APACHE II分数升高与特定的临床表现,并发症和年龄较大有关.
- 尽管有这些关联,但APACHE II评分系统被发现不适合作为预测COVID-19患者死亡的标准.
- 可能需要进一步的研究来确定更准确的COVID-19死亡率的预后标志物.
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