GIDS在老年AECOPD呼吸衰竭患者病情及预后评估中的应用OACSTPCD
Application of GIDS in the evaluation of disease severity and prognosis in elderly patients with AECOPD complicated with respiratory failure and its influence on prognosis
目的 探讨胃肠道功能障碍评分(GIDS)与老年慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭患者疾病严重程度的相关性及对预后的预测价值,为疾病严重程度和预后评估提供参考依据.方法 收集2020年1月至2023年8月于该院ICU治疗的264例老年AECOPD呼吸衰竭患者作为研究对象.根据患者GIDS,将患者分为低GIDS组(0～1分)和高GIDS组(2～4分).比较不同GIDS组患者急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和序贯器官衰竭评估(SOFA)评分,以及患者住院结局指标,包括机械通气时间、ICU入住时间和预后情况.采用Spearman相关分析GIDS与APACHE Ⅱ评分、SOFA评分的相关性.采用受试者工作特征(ROC)曲线分析GIDS对预后的预测价值.结果 264例老年AECOPD呼吸衰竭患者GIDS 为 2.00(1.00,3.00)分,其中0分53例(20.1％),1分65例(24.6％),2 分 53 例(20.1％),3 分 45 例(17.0％),4 分 48 例(18.2％).高 GIDS 组 APACHE Ⅱ 评分和 SOFA 评分高于低 GIDS 组(P＜0.05).Spearman相关性分析结果显示,GIDS与APACHE Ⅱ评分、SOFA评分均呈正相关(r=0.458、0.392,P＜0.05).高GIDS组机械通气时间、ICU入住时间长于低GIDS组,预后不良发生率高于低GIDS组,差异均有统计学意义(P＜0.05).ROC曲线结果显示,GIDS预测老年AECOPD呼吸衰竭患者预后不良的曲线下面积为0.823,灵敏度和特异度分别为93.4％和60.1％.结论 老年AECOPD呼吸衰竭患者GIDS与疾病严重程度密切相关,该评分对患者预后不良具有良好的预测价值.
Objective To explore the correlation between gastrointestinal dysfunction score(GIDS)and disease severity in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECO-PD)complicated with respiratory failure and its predictive value for prognosis,in order to provide reference basis for evaluation of disease severity and prognosis.Methods A total of 264 elderly AECOPD patients com-plicated with respiratory failure treated in the ICU of the hospital from January 2020 to August 2023 were col-lected as study subjects.According to the patients'GIDS,the patients were divided into low GIDS score group(0-1 score)and high GIDS group(2-4 scores).Acute Physiology and Chronic Health Status Scoring Sys-tem Ⅱ(APACHE Ⅱ)scores and Sequential Organ Failure Assessment(SOFA)scores of patients in differ-ent levels of GIDS groups were compared,as well as indicators of patients'hospitalization outcomes,including duration of mechanical ventilation,duration of ICU stay and prognosis.Spearman's correlation was used to an-alyze the correlation between GIDS and APACHE Ⅱ score and SOFA score.The predictive value of GIDS for prognosis was analyzed by receiver operating characteristic(ROC)curve.Results The mean GIDS of 264 eld-erly AECOPD patients with respiratory failure was 2.00(1.00,3.00),including 53 cases of zero(20.1％),65 cases of 1 point(24.6％),53 cases of 2 points(20.1％),45 cases of 3 points(17.0％)and 48 cases of 4 points(18.2％).APACHE Ⅱ score and SOFA score in the high GIDS group were higher than those in the low GIDS group(P＜0.05).Correlation analysis results showed that GIDS was positively correlated with APACHE Ⅱscore and SOFA score(r=0.458,0.392,P＜0.05).The mechanical ventilation time and ICU stay time in the high GIDS group were longer than those in the low GIDS group,while the incidence of poor prognosis was higher than that in the low GIDS group,with statistically significant differences(P＜0.05).The area under the curve of GIDS for predicting poor prognosis was 0.823,with sensitivity of 93.4％and specificity of 60.1％.Conclusion GIDS in elderly AECOPD patients complicated with respiratory failure is closely related to disease severity,and it has good predictive value for poor prognosis.
刘艳;王红梅;卢晓丽;杨菊荣;赵娟;杨春波;付晓乐
新疆医科大学第一附属医院重症医学一科,新疆乌鲁木齐 830054
临床医学
老年慢阻肺急性加重期呼吸衰竭胃肠道功能障碍评分疾病严重程度预后
elderlyacute exacerbation of chronic obstructive pulmonary diseaserespiratory failuregastrointestinal dysfunction scoredisease severityprognosis
《检验医学与临床》 2024 (016)
2324-2327,2333 / 5
省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2021-ZY13);新疆维吾尔自治区十三·五重点学科临床医学高峰学科新疆医科大学第一临临床医学院暨第一附属医院院内科研类课题(KYZD-03).
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