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目的:了解急诊患者连续性肾脏替代治疗(CRRT)的预后评价及死亡风险的预测因素。方法:回顾分析我院急诊监护室2005-05-2011-07接受CRRT治疗的217例患者。结果:217例急诊患者,中位年龄68(50～77)岁,应用Logistic回归分析影响死亡的危险因素,由大到小依次是呼吸机(P<0.001),APACHEⅡ评分(P<0.001),年龄(P=0.001)。应用ROC曲线计算APACHEⅡ评分、SOFA评分和乳酸的曲线下面积(AUC),分别为0.780(P<0.001)、0.723(P<0.001)、0.725(P<0.001)。结论:APACHEⅡ评分、SOFA评分和乳酸可用于CRRT患者死亡风险的预测,指导临床治疗。机械通气、APACHEⅡ评分和年龄与患者的死亡具有密切联系。
OBJECTIVE: To understand the prognostic evaluation of continuous renal replacement therapy (CRRT) in emergency patients and predictors of the risk of death. Methods: A retrospective analysis of 217 cases of CRRT treatment in emergency room of our hospital during 2005-05-2011-07. Results: Among 217 emergency patients, the median age was 68 (50-77) years old. Logistic regression analysis was used to analyze the risk factors of death. The descending order was ventilator (P <0.001), APACHEⅡ score (P <0.001) Age (P = 0.001). The APACHE II score, SOFA score and the area under the curve of lactate (AUC) were calculated by ROC curve, and were 0.780 (P <0.001), 0.723 (P <0.001) and 0.725 (P <0.001), respectively. Conclusion: APACHE Ⅱ score, SOFA score and lactic acid can be used to predict the risk of death in patients with CRRT, to guide clinical treatment. Mechanical ventilation, APACHEⅡscore and age were closely related to the patient’s death.