牛津急性疾病严重程度评分和生理评分系统对ICU患者病情评估的价值

目的 探讨牛津急性疾病严重程度评分（OASIS）和生理评分系统（PSS）在ICU患者病情评估和预后判断中的价值。方法 回顾性分析2016年8月至2017年8月在黄山市人民医院ICU住院的102例重症患者的临床资料，根据转归情况分为好转组（72例）与死亡组（30例），比较两组患者的OASIS和PSS评分，计算OASIS和PSS评分的受试者工作特征（ROC）曲线下面积。结果 好转组患者OASIS、PSS评分、机械通气时间分别为（24.64±5.95）分、（4.18±2.36）分和（3.36±3.97）d，死亡组患者为（34.60±7.17）分、（6.47±2.66）分和（8.13±9.36）d，两组差异有统计学意义（P<0.05）。OASIS的ROC曲线下面积为0.856（95% CI：0.770~0.942，P<0.05），评分为30.5分时Youden指数最大，为0.592。PSS评分的ROC曲线下面积为0.747（95% CI：0.637~0.858，P<0.05），评分为5.5分时Youden指数最大，为0.421。结论 OASIS对ICU患者的病情评估与预后优于PSS评分。

Value of Oxford Acute Severity of Illness Score and Physiological Scoring System in assessment of severity of critical care patients

Objective To explore the value of Oxford Acute Severity of Illness Score(OASIS) and Physiological Scoring System(PSS) in evaluating the severity and prognosis of critical care patients. Methods A total of102 patients admitted to our ICU from August 2016 to August 2017were retrospectively analyzed,among them 30 were in non-survivors group and 72in survivors group. OASIS,PSS and the area under the receiver operating characteristic(ROC) in survivors and non-survivors were calculated. Results OASIS, PSS score and duration of mechanical ventilation of survivors group were(24.64±5.95),(4.18±2.36) and(3.36±3.97)d respectively, those of non-survivors group were(34.60±7.17),(6.47±2.66) and(8.13±9.36)d, respectively, and there wasstatistically significant difference between the two groups(P<0.05).The area under the ROC of OASIS was 0.856(95%CI:0.770~0.942, P<0.05), Youden index wasthe biggest,namely 0.592,when OASIS was 30.5. The area under the ROC of PSS score was 0.747(95%CI:0.637~0.858, P<0.05),Youden index was the biggest,namely 0.421,when PSS score was 5.5. Conclusion Oxford Acute Severity of Illness Score is useful in evaluating the severity and prognosis of critical care patients and superior to PSS.