干旱区生态环境知识资源中心(Arid): 基于MIMIC-Ⅲ公共数据库评价六种重症评分对呼吸重症监护患者ICU死亡风险的预测价值

Arid

	基于MIMIC-Ⅲ公共数据库评价六种重症评分对呼吸重症监护患者ICU死亡风险的预测价值
其他题名	Evaluation on the predictive values of six critical illness scores for ICU mortality in respiratory intensive care unit based on MIMIC-Ⅲ database
	邹琳琳; 胡忠; 王进; 王洋
来源期刊	中国呼吸与危重监护杂志
ISSN	1671-6205
出版年	2021
卷号	20 期号:3 页码:1671-6205
中文摘要	目的评价6种常用重症评分对呼吸重症监护患者重症加强治疗病房(ICU)死亡风险的预测价值。方法从MIMIC-Ⅲ公共数据库提取2001年6月到2012年10月需要重症监护且出院主要诊断为呼吸系统疾病患者的临床资料,分别计算急性生理学评分(APS)Ⅲ、简化急性生理评分(SAPS)Ⅱ、牛津急性疾病严重程度评分(OASIS)、Logistic器官功能障碍系统评分(LODS)、全身炎症反应综合征评分(SIRS)、序贯器官衰竭评分(SOFA),以ICU死亡为结局事件,绘制受试者操作特征(ROC)曲线并计算曲线下面积(AUC)。依据入住ICU期间是否行有创机械通气将患者分为A、B两个亚组(A组:未行有创机械通气;B组:行有创机械通气),分别计算6种重症评分预测A、B亚组患者ICU死亡风险的AUC值并进行独立ROC曲线比较。结果共计纳入2988例患者,男性占比49.4%,年龄中位数67(55,79)岁,ICU死亡率13.2%。SAPSⅡ、LODS、APSⅢ、OASIS、SOFA、SIRS预测呼吸重症监护患者ICU死亡风险的AUC值分别为0.73(0.70,0.75)、0.71(0.68,0.73)、0.69(0.67,0.72)、0.69(0.67,0.72)、0.67(0.64,0.70)、0.58(0.56,0.62)。亚组分析显示A组患者,OASIS、SAPSⅡ、LODS、APSⅢ、SOFA、SIRS预测ICU死亡风险的AUC值分别为0.81(0.76,0.85)、0.80(0.75,0.85)、0.77(0.72,0.83)、0.75(0.70,0.80)、0.73(0.68,0.78)、0.63(0.56,0.69);B组患者,SAPSⅡ、APSⅢ、LODS、SOFA、OASIS、SIRS预测ICU死亡风险的AUC值分别为0.68(0.64,0.71)、0.67(0.63,0.70)、0.65(0.62,0.69)、0.62(0.59,0.66)、0.62(0.58,0.65)、0.57(0.54,0.61);独立ROC曲线比较结果显示OASIS、SAPSⅡ、LODS、APSⅢ、SOFA预测A、B两组患者AUC差值具有显著性差异,而SIRS评分AUC差值没有显著性差异。结论6种重症评分对呼吸重症监护患者ICU死亡风险的预测能力总体欠佳,预测有创机械通气患者ICU死亡风险能力差是一个重要原因。
英文摘要	Objective To evaluate the predictive value of critical illness scores for hospital mortality of severe respiratory diseases in respiratory intensive care unit (ICU).Methods The clinical data of the patients who needed intensive care and primary diagnosed with respiratory diseases from June,2001 to Octomber,2012 were extracted from MIMIC-Ⅲ database.The Acute Physiology Score (APS) Ⅲ,Simplified Acute Physiology Score (SAPS) Ⅱ,Oxford Acute Severity of Illness Score (OASIS),Logistic Organ Dysfunction System (LODS),Systemic Inflammatory Response Syndrome (SIRS) and Sequential Organ Failure Assessment (SOFA) were calculated according to the requirements of each scoring system.ICU mortality was set up as primary outcome and receiver operating characteristic (ROC) analysis was performed to evaluate the predictive performances by comparing the areas under ROC curve (AUC).According to whether they received invasive mechanical ventilation during ICU,the patients were divided into two groups (group A:without invasive mechanical ventilation group;group B:with invasive mechanical ventilation group).The AUCs of six scoring systems were calculated for groups A and B,and the ROC curves were compared independently.Results A total of 2 988 patients were recruited,male accounted for 49.4%,median age was 67 (55,79),and ICU mortality was 13.2%.The AUCs of SAPSⅡ,LODS,APSⅢ,OASIS,SOFA and SIRS were 0.73 (0.70,0.75),0.71 (0.68,0.73),0.69 (0.67,0.72),0.69(0.67,0.72),0.67 (0.64,0.70) and 0.58 (0.56,0.62).Subgroup analysis showed that in group A,the AUCs of OASIS,SAPSⅡ,LODS,APSⅢ,SOFA and SIRS were 0.81 (0.76,0.85),0.80 (0.75,0.85),0.77 (0.72,0.83),0.75 (0.70,0.80),0.73(0.68,0.78) and 0.63 (0.56,0.69) in the prediction of ICU mortality;in group B,the AUCs of SAPSⅡ,APSⅢ,LODS,SOFA,OASIS and SIRS were 0.68 (0.64,0.71),0.67 (0.63,0.70),0.65 (0.62,0.69),0.62 (0.59,0.66),0.62 (0.58,0.65) and 0.57 (0.54,0.61) in the prediction of ICU mortality.The results of independent ROC curve showed that the AUC differences between groups A and B were statistically significant in terms of OASIS,SAPSⅡ,LODS,APSⅢ and SOFA,but there were no significant differences in SIRS.Conclusions The predictive values of six critical illness scores for ICU mortality in respiratory intensive care are low.Lack of ability to predict ICU mortality of patients with invasive mechanical ventilation should hold primary responsibility.
中文关键词	评分体系 ; 肺疾病/病理生理学 ; 危重病 ; 简化急性生理评分 ; 牛津急性疾病严重程度评分 ; Logistic器官功能障碍系统评分 ; 急性生理学评分 ; 全身炎症反应综合征评分 ; 序贯器官衰竭评分
英文关键词	Scoring system Pulmonary disease/physiopothology Critical/illness Simplified Acute Physiology Score Oxford Acute Severity of Illness Score Logistic Organ Dysfunction System Acute Physiology Score Systemic Inflammatory Response Syndrome Sequential Organ Failure Assessment
类型	Article
语种	中文
国家	中国
收录类别	CSCD
WOS类目	General & Internal Medicine
CSCD记录号	CSCD:6978826
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/365422
作者单位	邹琳琳, 重庆两江新区第一人民医院呼吸与危重症医学科, 重庆 401121, 中国.; 胡忠, 重庆两江新区第一人民医院呼吸与危重症医学科, 重庆 401121, 中国.; 王进, 重庆两江新区第一人民医院呼吸与危重症医学科, 重庆 401121, 中国.; 王洋, 重庆两江新区第一人民医院呼吸与危重症医学科, 重庆 401121, 中国.
推荐引用方式 GB/T 7714	邹琳琳,胡忠,王进,等. 基于MIMIC-Ⅲ公共数据库评价六种重症评分对呼吸重症监护患者ICU死亡风险的预测价值[J],2021,20(3):1671-6205.
APA	邹琳琳,胡忠,王进,&王洋.(2021).基于MIMIC-Ⅲ公共数据库评价六种重症评分对呼吸重症监护患者ICU死亡风险的预测价值.中国呼吸与危重监护杂志,20(3),1671-6205.
MLA	邹琳琳,et al."基于MIMIC-Ⅲ公共数据库评价六种重症评分对呼吸重症监护患者ICU死亡风险的预测价值".中国呼吸与危重监护杂志 20.3(2021):1671-6205.