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
白景山 1张嘉宾 2刘聪辉 3陈前程 2付爱双 2喻昌利 2董爱英 4张婉5
作者信息
- 1. 071700 河北雄安新区,雄安宣武医院呼吸与危重症医学科
- 2. 华北理工大学附属医院呼吸与危重症医学科
- 3. 华北理工大学附属医院内分泌科
- 4. 华北理工大学附属医院临床微生物科
- 5. 华北理工大学附属医院工会
- 折叠
摘要
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.
Abstract
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.
关键词
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Key words
Acute exacerbation of chronic obstructive pulmonary disease/Scoring system/Hypersen-sitive C-reactive protein/Serum amyloid A/Procalcitonin引用本文复制引用
出版年
2024
NETL
NSTL
万方数据