查尔森合并症指数预测基础疾病对肺炎患者预后的影响
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查尔森合并症指数预测基础疾病对肺炎患者预后的影响
作者：崔云亮 王涛 田昭涛 吴相伟 林兆奋 陈德昌
来源：《中华急诊医学杂志》2013年第07期
【摘要】目的 应用查尔森合并症指数（Charlson’s weighted index of comorbidities， WIC）评价基础疾病对ICU 肺部感染患者28 d死亡风险的影响。方法 回顾性分析上海长征医院2010年10月至2012年2月的160例肺部感染患者，临床资料包括年龄、性别、社区获得性肺炎（CAP ）或者院内获得性肺炎（HAP ）、基础疾病、是否发生急性呼吸窘迫综合征
（ARDS ）、是否严重脓毒症和28 d病死率；入院24 h内计算WIC 评分、急性生理与慢性健康状况（APACHE ）Ⅱ评分和脓毒症相关性器官功能衰竭评分（sepsis related organ failure assessment ，SOFA ）评分。用Logistic 回归分析影响患者预后的因素，绘制受试者工作曲线（ROC ）比较各评分对预后的判断。结果 在160例入组患者中，CAP 患者76例（48.8%），HAP 患者82例（51.2%），男性106例（66.3%），女性54例（33.7%），存活99例
（61.9%），死亡61例（38.1%）。年龄（62.4±17.3）岁。与存活组比较，死亡组的WIC 分值、APACHE Ⅱ分值和SOFA 评分较高（P
【关键词】查尔森合并症指数；急性生理与慢性健康状况评分Ⅱ；脓毒症相关性器官功能衰竭评分；肺部感染；预后
Weighted index of comorbidities evaluates the impact of underlying diseases on hospital
mortality of pneumonia patients CUI Yun-liang，WANG Tao，TIAN Zhao-tao，WU Xiang-wei，LIN Zhao-fen， CHEN De-chang. Department of Emergency Medicine，Jinan Military General Hospital ， Jinan 250031，China
Corresponding author：CHEN De-chang，Email ：[email protected]
【Abstract 】Objective To estimate the validity of Charlson’s weighted index of comorbidities （WIC ） used to predicting 28-day mortality among ICU pneumonia patients with underlying
diseases. Methods A retrospective analysis of 160 adult patients with pneumonia admitted to a multi-discipline ICU of Shanghai Changzheng hospital between October 2010 and February 2012 was carried out. Clinical data were collected including age， gender， community acquired pneumonia （CAP ） or hospital acquired pneumonia （HAP ）， underlying diseases， severity-of-sepsis， and 28-day mortality. WIC scores， acute physiology and chronic health evaluation （APACHE ） Ⅱ， and sepsis related organ failure assessment （SOFA ） were assessed within the first 24 hours after admission. Logistic regression analyses were used to evaluate the predictors for outcome. The receiver operating characteristic curve （ROC ） was used to compare the performance of these scores between different methods. Results Of 160 enrolled patients， 76 （48.8%） were CAP， 82