Predictive value of APACHE Ⅱ score combined with CVP in hospital death of patients with septic shock
Objective To explore the predictive value of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score combined with CVP in the hospital death of the patients with septic shock.Methods According to 28-day inhospital death,307 patients with septic shock were divided into death group(106 cases)and non-death group(201 cases).The clinical data and relevant laboratory indicators of the two groups were compared.The risk factors for inhospital death of the patients with septic shock were analyzed by multivariate logistic regression.The ROC curve was drawn to analyze the predictive efficacy of APACHE Ⅱ score and CVP alone and in combination in predicting inhospital death of the patients with septic shock.Results Compared with non-death group,death group had older age,higher proportions of needing continuous renal replacement therapy,mechanical ventilation,longer duration of mechanical ventilation,higher proportion of lung disease,and higher scores of sequential organ failure assessment(SOFA)(P＜0.05 or P＜0.01).Compared with non-death group,death group had higher CVP,pH,lactic acid,international normalized ratio,ALT and AST,longer prothrombin time and activated partial thromboplastin time,and lower albumin(P＜0.05 or P＜0.01).The need for mechanical ventilation and higher CVP,SOFA and APACHE Ⅱ scores were the independent risk factors for inhospital death of the patients with septic shock(P＜0.05 or P＜0.01).The AUC of combined use of APACHEⅡ score and CVP in predicting inhospital death in the patients with septic shock was 0.836,and sensitivity and specificity were 77.4％and 75.1％,respectively.Conclusion Higher APACHE Ⅱ score and CVP are the independent risk factors for inhospital death of the patients with septic shock.Combined use of APACHE Ⅱ score and CVP has higher predictive value.
Acute physiology and chronic health evaluation Ⅱ scoreCentral venous pressureSeptic shock
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