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在慢性重症中预测死亡率的APACHE II和NUTRIC得分:一种"右侧"的预测建模方法

Dmitrij V Zhidilyaev¹, Levan B Berikashvili², Mikhail Ya Yadgarov²

¹Moscow City Health Department, State Budgetary Institution Konchalovsky City Clinical Hospital, 124489 Moscow, Russia.

Diagnostics (Basel, Switzerland)

|December 30, 2025

概括

像APACHE II和NUTRIC这样的预后得分更准确地预测了临死临近的慢性重症患者的死亡率. 当从结果进一步评估时,它们的预测能力显著下降,突出显示了对动态工具的需求.

科学领域:

临界护理医学临界护理医学
预测模型的预测建模
神经损伤神经损伤

背景情况:

慢性严重疾病 (CCI) 后脑损伤的预后具有挑战性.
传统的评分系统 (APACHE II,NUTRIC) 被验证为基于入学的模型.
它们的准确性可能在预测长期疾病轨迹的结果方面有限.

研究的目的:

评估APACHE II和NUTRIC分数作为"右侧"预后模型.
测试是否医院内死亡率的预测准确性在评估得分接近死亡时有所改善.
在CCI患者中假设"右侧"模型的性能提高.

主要方法:

来自俄罗斯重症监护数据集 (RICD v. 2.0) 的现实数据分析.
包括328名成年患者在脑损伤后患有CCI.
使用接收器操作特征曲线 (AUROC) 下面的区域在死亡前≤7,8-14和≥15天评估预后性能.

主要成果:

预测性表现在死亡7天内达到顶峰 (APACHE II AUROC:0.883;NUTRIC AUROC:0.839). 在死亡的7天内,预测性表现达到顶峰 (APACHE II AUROC:0.883;NUTRIC AUROC:0.839).
辨别能力在8-14天显著下降,在死亡前≥15天最差.
在所有时间间隔中,NUTRIC得分显示AUROC值始终高于APACHE II值.

结论:

在CCI患者中,APACHE II和NUTRIC评分的预后准确性是时间依赖的.
评分在死亡之前是最准确的,从入院开始的长期预测价值很差.
需要动态,个性化和时间敏感的预后工具,用于发展慢性重症.

关键词:

亚太地区的第二个亚太地区.营养成分营养成分慢性危急疾病慢性危急疾病死亡率死亡率开放数据集是一个开放的数据集.预后预后预后

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