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目的:评估应用序贯性器官功能衰竭评价(SOFA)评分对急诊室使用无创正压通气(NPPV)治疗的患者进行病情预后的价值。方法:回顾我科2010年1月-2012年10月使用NPPV患者104例的临床资料,记录入院24 h内的SOFA评分,以死亡或需无创转换气管插管者为预后不良组(A组,n=54),成功脱机者为预后良好组(B组,n=50),利用ROC曲线评价SOFA评分对无创正压通气患者的预后评估价值。结果:A组SOFA评分(8.06±2.96)和中位数(四分位数间距)[8(6-10)]明显高于B组的SOFA评分(4.60±1.94)和中位数(四分位数间距)[4(3-6)](P<0.05)。SOFA评分对预后判断ROC曲线下面积为0.810(P<0.001),Cutoff值为>5,敏感度为83.33%((70.7-92.1),特异度为60.8%(53.3-80.5)。阳性预测值73.8%(60.9-84.2),阴性预测值79.1%(64.0-90.0)。结论 :SOFA评分对急诊室使用NPPV治疗患者的预后有较好预测价值。
PURPOSE: To assess the value of using the SOFA score to assess the prognosis of patients undergoing noninvasive positive pressure ventilation (NPPV) in the emergency department. Methods: The clinical data of 104 patients with NPPV admitted to our department from January 2010 to October 2012 were retrospectively analyzed. SOFA scores within 24 hours after admission were recorded. Those with or without endotracheal intubation undergoing tracheal intubation were considered as poor prognosis group (group A, (n = 54). The patients who were successfully off-line were in the good prognosis group (group B, n = 50). The ROC curve was used to evaluate the prognostic value of SOFA in non-invasive positive pressure ventilation. Results: SOFA score (8.06 ± 2.96) and median (interquartile range) [8 (6-10)] in group A were significantly higher than those in group B (4.60 ± 1.94) and median Digit spacing) [4 (3-6)] (P <0.05). The area under the ROC curve of the SOFA score was 0.810 (P <0.001), the cutoff value was> 5, the sensitivity was 83.33% (70.7-92.1) and the specificity was 60.8% (53.3-80.5) .The positive predictive value was 73.8 % (60.9-84.2), and the negative predictive value was 79.1% (64.0-90.0) .Conclusion: SOFA score has a good predictive value for the prognosis of emergency room patients treated with NPPV.