首页|基于年龄与血清炎症因子的AECOPD超时长住院评分系统的构建及评价

基于年龄与血清炎症因子的AECOPD超时长住院评分系统的构建及评价

Construction and evaluation of a scoring system for predicting AECOPD extended hospitalization based on age and serum inflammatory factors

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目的 探究年龄、血清炎症因子与慢性阻塞性肺疾病急性加重期(AECOPD)患者超时长住院的关系,构建以年龄、血清炎症因子为基础的评分系统,并评价其预测能力.方法 回顾性分析华北理工大学附属医院2020年10月—2022年10月收治的391例AECOPD患者临床资料,根据AECOPD平均住院时间16天为划分指标,将纳入患者分为标准时长组(260例)和超时长组(131例),筛选出与AECOPD超时长住院的独立危险因素构建评分系统.结果 AECOPD标准时长组与超时长组中年龄、超敏C反应蛋白(hs-CRP)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)是AECOPD患者超时长住院的独立危险因素(P<0.05),而白细胞(WBC)、中性粒细胞(NEU)、纤维蛋白原(FIB)、红细胞沉降率(ESR)不是AECOPD患者超时长住院的独立危险因素(P>0.05).根据约登指数最大原则筛选预测的临界值,计算Kappa值,该模型的曲线下面积(AUC)为0.899,灵敏度82.4%,特异度86.2%,Kappa值0.669,具有较好的预测值和计算结果.结论 建立的预测AECOPD患者超时长住院的评分系统具有一定的准确性,并且对该类患者中高危患者及早进行识别及干预,对临床医师决策具有一定指导和应用价值.
Objective To explore the relationship between age,serum inflammatory factors and prolonged hospitalization in patients with AECOPD,to construct a scoring system based on age and serum inflammatory factors,and to evaluate it's predictive ability.Methods The clinical information of three hundred and ninety-one patients with AECOPD admitted to the affiliated Hospital of North China University of Science and Tech-nology from October 2020 to October 2022 were retrospectively analyzed.According to the average hospital stay of 16 days in AECOPD,the patients were divided into a standard-length group(n=260)and an over-time group(n=131).The independent risk factors associated with AECOPD were screened out to construct a scoring system.Results Age,hs-CRP,SA A and PCT were independent risk factors for prolonged hospi-talization of AECOPD patients in the AECOPD standard length group and overtime length group,while WBC,NEU,FIB and ESR were not independent risk factors for prolonged hospitalization of AECOPD pa-tients.According to the maximum principle of the Jorden index,the critical value of prediction was screened and Kappa value was calculated.The area under the curve(AUC)of the model was 0.899.Sensitivity was 82.4%,and specificity was 86.2%.Kappa value was 0.669,which had a good predictive value and calculation result.Conclusion The established scoring system for predicting prolonged hospitalization of AECOPD pa-tients has a certain accuracy,and early identification and intervention of high-risk patients in this kind of pa-tients has a certain guidance and application value for clinicians'decision-making.

Acute exacerbation of chronic obstructive pulmonary diseaseScoring systemHypersen-sitive C-reactive proteinSerum amyloid AProcalcitonin

白景山、张嘉宾、刘聪辉、陈前程、付爱双、喻昌利、董爱英、张婉

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071700 河北雄安新区,雄安宣武医院呼吸与危重症医学科

华北理工大学附属医院呼吸与危重症医学科

华北理工大学附属医院内分泌科

华北理工大学附属医院临床微生物科

华北理工大学附属医院工会

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慢性阻塞性肺疾病急性加重期 评分系统 超敏C反应蛋白 血清淀粉样蛋白A 降钙素原

河北省卫生厅项目

20160221

2024

中国煤炭工业医学杂志
河北联合大学

中国煤炭工业医学杂志

CSTPCD
影响因子:0.692
ISSN:1007-9564
年,卷(期):2024.27(2)
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