Pcv-aCO2/Ca-cvO2联合快速序贯器官功能衰竭评分对老年感染性休克病人预后的预测价值

doi:10.3969/j.issn.1003-9198.2021.10.008

摘要/Abstract

摘要： 目的评估中心静脉动脉二氧化碳分压差与氧含量差的比值(Pcv-aCO₂/Ca-cvO₂)联合快速序贯器官功能衰竭评分(qSOFA)对老年感染性休克病人预后的预测价值。方法选择2017~2020年我科收治的68例老年感染性休克病人,根据28 d预后分为存活组(n=38)和死亡组(n=30),比较2组病人的临床资料、Pcv-aCO₂/Ca-cvO₂、qSOFA评分及APACHEⅡ评分,采用Logistic回归分析老年感染性休克病人预后的影响因素。采用ROC曲线分析Pcv-aCO₂/Ca-cvO₂、qSOFA及两指标联合对老年感染性休克病人预后的预测价值。结果死亡组病人的肌酐、降钙素原、Pcv-aCO₂/Ca-cvO₂水平,及qSOFA评分、APACHEⅡ评分均显著高于存活组(P<0.05);Logistic回归模型分析结果显示,Pcv-aCO₂/Ca-cvO₂、qSOFA、APACHEⅡ是老年感染性休克病人预后的独立影响因素。ROC曲线分析结果显示,Pcv-aCO₂/Ca-cvO₂、qSOFA预测老年感染性休克病人预后的灵敏度分别为70.00%、53.33%;而两指标联合预测预后的灵敏度为80.00%,优于单一指标。结论 Pcv-aCO₂/Ca-cvO₂、qSOFA、APACHEⅡ是老年感染性休克病人预后的独立影响因素。Pcv-aCO₂/Ca-cvO₂联合qSOFA在老年感染性休克病人预后的预测中具有一定价值。

关键词: 老年人, 感染性休克, Pcv-aCO₂/Ca-cvO₂, 快速序贯器官功能衰竭评分, 预后, 预测价值

Abstract: Objective To evaluate the predictive value of Pcv-aCO₂/Ca-cvO₂ combined with quick sequential organ failure assessment (qSOFA) on the prognosis of elderly patients with septic shock. Methods A total of 68 elderly patients with septic shock admitted to Emergency ICU from January 2017 to December 2020 were selected and divided into survival group (n=38) and death group (n=30) according to the 28 d prognosis. The clinical data, the ratio of Pcv-aCO₂/Ca-cvO₂, and the scores of qSOFA and Acute Physiology and Chronic Health Evulation (APACHEⅡ) were compared between the two groups. The influencing factors of prognosis were analyzed by Logistic regression model. The predictive value of Pcv-aCO₂/Ca-cvO₂, qSOFA and their combination on the prognosis of elderly patients with septic shock was analyzed by receiver operating characteristic (ROC) curve analysis. Results The levels of creatinine, procalcitonin, Pcv-aCO₂/Ca-cvO₂, and the scores of qSOFA and APACHE Ⅱ in the death group were siginificantly higher than those in the survival group (P<0.05); Logistic regression analysis showed that Pcv-aCO₂/Ca-cvO₂, qSOFA and APACHE Ⅱ were the independent influencing factors of prognosis in the elderly patients with septic shock. ROC curve analysis showed that the sensitivity of Pcv-aCO₂/Ca-cvO₂ and qSOFA in predicting the prognosis of elderly patients with septic shock was 70.00% and 53.33%, respectively; The sensitivity of the combination of the two indexes in predicting the prognosis was 80.00%, which was better than the single index. Conclusions Pcv-aCO₂/Ca-cvO₂, qSOFA and APACHE Ⅱ are independent influencing factors for the prognosis in the elderly patients with septic shock. The combination of Pcv-aCO₂/Ca-cvO₂ and qSOFA has a certain value in predicting the prognosis of elderly patients with septic shock.

Key words: aged, septic shock, Pcv-aCO₂/Ca-cvO₂, quick sequential organ failure assessment, prognosis, predictive value

中图分类号:

R 631.4

赵婷婷, 王慧, 薛乾隆, 李文卉, 韩树池. Pcv-aCO₂/Ca-cvO₂联合快速序贯器官功能衰竭评分对老年感染性休克病人预后的预测价值[J]. 实用老年医学, 2021, 35(10): 1027-1030.

ZHAO Ting-ting, WANG Hui, XUE Qian-long, LI Wen-hui, HAN Shu-chi. Predictive value of Pcv-aCO₂/Ca-cvO₂ combined with quick sequential organ failure assessment on prognosis of elderly patients with septic shock[J]. Practical Geriatrics, 2021, 35(10): 1027-1030.

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Pcv-aCO₂/Ca-cvO₂联合快速序贯器官功能衰竭评分对老年感染性休克病人预后的预测价值

Predictive value of Pcv-aCO₂/Ca-cvO₂ combined with quick sequential organ failure assessment on prognosis of elderly patients with septic shock

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