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目的 通过APACHE II、SOFA、CPIS、PSI评分系统对呼吸机相关性肺炎预后评估价值的比较,探索PSI评分对呼吸机相关性肺炎的预后评估价值.方法 采用回顾性队列研究方法,将2017年7月1日-2018年7月1日期间徐州医科大学附属医院急诊重症医学科科符合我国2018年VAP诊断标准的80例患者,以患者28 d病死率为预后指标,按患者存活或非存活进行二分类Logistic回归分析,采用受试者工作特征曲线(receiver operating characteristic,ROC)评价各评分系统对预后的判定能力并确定预后的界值.结果 80例VAP患者28 d死亡率为41.25%.非存活组发生VAP当日及离开EICU当日的APACHEⅡ、CPIS、SOFA及PSI评分均明显高于存活组,且发生VAP当日的PSI＞115分是VAP患者死亡的独立危险因素(P＝0.002);离开EICU当日的APACHE II＞23分及SOFA＞6分也是VAP患者的独立危险因素(P值分别为:0.027,0.015).APACHE II、SOFA、CPIS、PSI评分ROC AUC分别为0.710(95%CI 0.597~0.822),0.649(95%CI 0.527~0.771),0.624(95%CI 0.501~0.748),0.736(95%CI 0.627~0.845).结论 PSI评分与APACHE II、SOFA、CPIS等评分一样可以应用到VAP患者预后评估,效应与APACHE II相当,且优于SOFA及CPIS评分.“,”Objective To investigate the value of PSI score system in assessing the prognostic value in patients with ventilator-associated pneumonia (VAP). Methods A retrospective cohort study was conducted on 80 patients who met the VAP diagnostic criteria of 2018 in emergency intensive care unit (EICU) of our hospital from July 1, 2017 to July 1, 2018. The 28-day mortality of the patients were used as prognostic factors.Bicategorized logistic regression analysis was performed according to survival or non-survival of the patients. The receiver operating characteristic curve (ROC) was used to evaluate the prognostic value of each scoring system and to determine the prognostic threshold of these scoring systems. Results The 28-day mortality rate of 80 patients with VAP was 41.25% . APACHE II, CPIS, SOFA and PSI score systems on the day of VAP occurrence and the day of EICU in non-survival group were significantly higher than those in survival group, and PSI＞115 score on the day of VAP occurrence was an independent risk factor for VAP mortality (P＝0.002); APACHE II＞23 score and SOFA＞6 score on the day of EICU were also independent risk factors for patients with VAP (P value were 0.027, 0.015, respectively). The areas under ROC curves for evaluating the prognosis of patients with VAP according to APACHE II, SOFA, CPIS and PSI were 0.710 (95% CI 0.597-0.822), 0.649 (95% CI 0.527-0.771), 0.624 (95% CI 0.501-0.748) and 0.736 (95% CI 0.627-0.845), respectively. Conclusion PSI score system, as well as APACHE II,SOFA and CPIS score systems, can be applied to the prognosis assessment of the patients with VAP. The effect is comparable to APACHE II and superior to SOFA and CPIS score systems.