Predictive Value of APACHE Ⅱ Score Combined with Red Blood Cell Distribution Width in Risk of Death in Patients with Colonic Perforation Complicated with Septic Shock
Objective To investigate the predictive value of acute physiological and chronic health score(APACHE Ⅱ)combined with red blood cell distribution width(RDW)in the risk of death in patients with colonic perforation complicated with septic shock.Methods A total of 80 patients with colonic per-foration complicated with septic shock were selected from June 2019 to December 2022,and the APACHEⅡ score and RDW of the patients were counted.The patients were followed up for 2 months after admis-sion.According to the prognosis of the patients in the two months,total 68 patients were classified as the non-death group and 12 patients were classified as the death group.The clinical data of all patients were collected,and the prognosis of 80 patients with colon perforation complicated with septic shock was ana-lyzed.The clinical data of the two groups were compared.The risk factors of death in patients with colon perforation complicated with septic shock within 2 months were analyzed by Logistic multivariate regres-sion,and the receiver operating characteristic curve(ROC)was drawn.Area under the curve(AUC)was used to evaluate the predictive value of APACHE Ⅱ score and RDW in the risk of death in patients with colonic perforation complicated with septic shock.Results After 2 months of follow-up,12 of the 80 pa-tients died,the mortality rate was 15.00％(12/80),which was recorded as the death group,and 68 patients survived,the survival rate was 85.00％(68/80),which was recorded as the non-death group.There was no significant difference in age,sex,smoking,drinking,complicated by hypertension or diabetes,alanine amin-otransferase(ALT)and D-dimer(D-D)between the two groups(P＞0.05).APACHE Ⅱ score in the death group was higher than that in the non-death group(P＜0.05).The RDW in the death group was lower than that in the non-death group(P＜0.05).Whether the patients with colonic perforation com-plicated with septic shock died within 2 months was the dependent variable(no=0,yes=1),and APACHEⅡ score and RDW were the independent variables for Logistic multivariate regression analysis(all continu-ous variables).It showed that APACHE Ⅱ score and RDW were risk factors for 2-month death in patients with colonic perforation complicated with septic shock(P＜0.05).ROC curve results showed that A-PACHE Ⅱ score,RDW and the AUC value(95％CI)of their combination in predicting 2-month death in patients with colonic perforation complicated with septic shock were 0.761(0.617-0.905),0.695(0.523-0.867),and 0.876(0.750-1.000),respectively(P＜0.05).Conclusion APACHE Ⅱ score and RDW have important value in predicting the risk of short-term death in patients with colonic perforation compli-cated with septic shock,and the combination of the two has higher predictive value.
Colon perforation complicated with septic shockAcute physiology and chronic healthRed blood cell distribution widthRisk of deathPredictive value
NETL
NSTL
万方数据
