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目的:研究目前常用的三种评分SAPS 3、APACHEⅡ和APACHEⅣ对重症患者的预测效力、相关性。方法:前瞻性收集中国医学科学院肿瘤医院重症医学科(ICU)2008-10-2010-09收治的全部患者的资料。通过受试者工作曲线(ROC)显示三种评分预测ICU患者28d病死率的能力。通过Bivariate分析比较三种评分的相关性。结果:981例患者进入最后的分析。三种评分能很好地预测危重患者28d病死率。SAPS 3,AUC=0.948(95%CI 0.914~0.982,P<0.01);APACHEⅡ,AUC=0.863(95%CI 0.804~0.923,P<0.01);APACHEⅣ,AUC=0.873(95%CI0.813~0.934,P<0.01)。相关分析发现SAPS 3、APACHEⅡ、APACHEⅣ三种评分之间明显相关(R2:0.514~0.705,P<0.01)。结论:三种评分对于ICU患者的28d病死率的预测能力相当。三种预后评分方面存在明显的相关性。
OBJECTIVE: To study the predictive efficacy and correlation of the three commonly used scores of SAPS 3, APACHEⅡ and APACHE Ⅳ in critically ill patients. Methods: Prospectively collect the data of all patients admitted to the Intensive Care Unit (ICU) of Cancer Hospital of Chinese Academy of Medical Sciences from 2008-10-2010-09. The receiver operating curve (ROC) shows the ability of the three scores to predict the 28-day mortality in ICU patients. The correlation of the three scores was compared by Bivariate analysis. Results: 981 patients entered the final analysis. The three scores are good predictors of 28-day mortality in critically ill patients. APACHEⅣ, AUC = 0.948 (95% CI 0.914-0.982, P <0.01); APACHEⅡ, AUC = 0.863 (95% CI 0.804-0.923, , P <0.01). Correlation analysis showed that SAPS 3, APACHE Ⅱ, APACHE Ⅳ three scores were significantly correlated (R2: 0.514 ~ 0.705, P <0.01). CONCLUSIONS: The three scores have similar predictive power for 28-day mortality in ICU patients. There was a clear correlation between the three prognostic scores.