在埃及患者中,P-POSSUM和NELA风险评分对接受紧急腹腔切除术的患者进行比较
Mahmoud Magdy Alabbasy1, Alaa Abd Elazim Elsisy2, Adel Mahmoud3
1Department of General Surgery, Faculty of Medicine, Menoufia University, Shebin-Elkom, Menoufia, Egypt. mahmoud.magdy710@med.menofia.edu.eg.
BMC surgery
|September 22, 2023
概括
这项研究比较了国家紧急 laparotomy 审计 (NELA) 和波茨斯-生理和操作严重性评分,以列举死亡率和发病率 (P-POSSUM) 评分. 这两个评分都低估了紧急腹腔切除术患者的死亡风险.
科学领域:
- 紧急医疗 紧急医疗
- 外科手术的结果
- 风险分层是风险的分层.
背景情况:
- 死亡率和发病率 (P-POSSUM) 计数的波茨斯生理和操作严重性得分被广泛用于预测紧急腹腔切除术中的死亡率.
- 国家紧急拉皮切除术审计 (NELA) 提供了一个新的,经过验证的评分,用于评估这一患者群体的风险.
研究的目的:
- 为了比较NELA和P-POSSUM得分对30天和90天死亡率的预测性表现,在接受紧急腹腔切除术的患者中.
- 评估手术前和手术后的NELA分数与P-POSSUM分数的区分能力.
主要方法:
- 2020年8月至2022年10月期间在Menoufia大学医院进行的一组研究.
- 使用曲线下的面积 (AUC) 进行歧视,比较P-POSSUM,手术前的NELA和术后的NELA得分.
- 数据收集包括计算得分和30/90天死亡结果所需的所有变量.
主要成果:
- 在670名患者中,观察到的30天死亡率为10.3%,90天死亡率为13.13%.
- 对于30天死亡率,AUC为:手术前NELA0.774,P-POSSUM0.763,手术后NELA0.780. 在手术后,AUC为:手术前NELA0.774,P-POSSUM0.763,术后NELA0.780.
- 对于90天的死亡率,AUC为:手术前NELA0.649,P-POSSUM0.782,手术后NELA0.663. 这些是AUC值. 双对对比显示了歧视的显著差异.
结论:
- 无论是NELA还是P-POSSUM分数都低估了研究群体中实际的30天和90天死亡风险.
- 在NELA和P-POSSUM评分系统之间的预测性能存在明显的差异.
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