两种评分法对心肺复苏自主循环恢复昏迷病人预后预测的比较

目的评价APACHEⅡ评分和CPRROSC预后评分对CPRROSC病人预后的预测价值。方法分别对115例CPRROSC病人进行APACHEⅡ评分和CPRROSC预后评分,比较不同预后病人各分数之间的差异;计算并比较两种评分法对病人严重预后不良和其他预后类型区别能力的ROC曲线下面积。结果5种不同预后之间比较,两种评分方法均有显著性差异(APACHEⅡF=57.64,P=0.000;CPRROSC预后评分,F=65.91,P=0.000)。反映评分区分严重不良预后(植物状态或死亡)能力的ROC曲线下面积分别为CPRROSC预后评分0.950,APACHEⅡ评分0.937,2者差异无统计学意义(P>0.05)。结论APACHE II评分和CPRROSC预后评分总体上均能区分严重不良预后与其他预后类型,可作为心肺复苏自主循环恢复昏迷病人不良预后的预测、评价工具。

A comparative study on Two Scoring Approaches to Prognosis of comatose patients with return of spontaneous circulation after cardiopulmonary resuscitation

Objective To evaluate the outcome predicting values of APACHE Ⅱ and CPRROSC in comatose patients with return of spontaneous circulation after cardiopulmonary resuscitation(CPRROSC).Methods The data of 115 CPRROSC patients were collected and scored with APACHE Ⅱ and CPRROSC respectively and scores were compared among five different outcomes(good cerebral performance,moderate cerebral disability,severe cerebral disability,vegetative state and death).Areas under ROC curve of discrimination power for two categories of patients with poor outcomes and other patients were compared between APACHE Ⅱ and CPRROSC score.Results There was significant difference in scores of APACHE Ⅱ for five different outcomes(F=57.64,P=0.000),and so it is with CPRROSC(F=65.91,P=0.000).There was no significant difference in areas under ROC curve between APACHE Ⅱ(0.937) and CPRROSC(0.950) to discriminate the two categories of patients with poor outcomes and other patients.Conclusion Asa whole APACHE Ⅱ and CPRROSC have great value to predict outcome of CPRROSC patients.They may be used as tools to discriminate the two categories of patients with poor outcomes and other patients.