Prediction of outcome of elderly patients with respiratory failure: comparison of current scoring systems
- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.1003-0603.2011.04.003
- Key Word:
- 老年人;呼吸衰竭;急性生理学与慢性健康状况评分系统;简化急性生理学评分;多器官功能障碍评分;The elderly;Respiratory failure;Acute physiology and chronic health evaluation;Simplified acute physiology score;Multiple organ dysfunction score
Abstract： Objective To evaluate the predictive power of current scoring systems applied in elderly patients with respiratory failure. Methods Data of 159 elderly patients with respiratory failure, also meeting the criteria of multiple organ dysfunction syndrome in the elderly (MODSE), being admitted to PLA General Hospital from January 2009 to March 2010 were analyzed with four scoring systems, i.e. acute physiology and chronic health evaluation (APACHE Ⅱ , APACHE Ⅲ ), simplified acute physiology score Ⅱ (SAPS Ⅱ ),as well as multiple organ dysfunction score (Marshall score), for the prediction of their outcome on the first day after admission, and the predictive power of respective system was compared. Results One hundred and fifty-nine patients were involved, with a mean age of (75.26±7. 87) years, and a 28-day mortality of 53. 5%. Incidence of organ failure and prognosis scores in nonsurvivors were significantly higher than those in survivors (APACHE Ⅱ score: 27. 88 ± 8. 19 vs. 17.73 ± 6.21; APACHE Ⅲ score: 101.10 ± 29. 81 vs.64. 24±21.98; SAPS Ⅱ score: 59. 70±17.68 vs. 38. 05±12. 10; Marshall score: 8. 59±3. 15 vs. 4. 90±2. 66; organ failure: 4. 60±1.14 vs. 2. 88±0. 88, all P＜0. 01). Among the four scoring systems, SAPS Ⅱpresented excellence in sensitivity (91.76 % ), while APACHE Ⅲ in specificity (91.89 % ). Area under curve of receiver operator characteristic of all scoring systems reached 0. 820 (0. 829 for APACHE Ⅱ , 0. 836 for APACHE Ⅲ , 0. 844 for SAPS Ⅱ , 0. 820 for Marshall score). Conclusion All the four current scoring systems, i.e. APACHE Ⅱ , APACHE Ⅲ , SAPS Ⅱ and Marshall score, presented satisfactory predictive power in prognosis of elderly patients with respiratory failure.
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