查尔森合并症指数预测基础疾病对肺炎患者预后影响.docVIP

查尔森合并症指数预测基础疾病对肺炎患者预后影响 　　【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：icudcchen@ 　　【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 （51.2%） HAP， and 106 （66.3%） male， 54 （3