Two Scoring Systems For Predicting Non-invasive Ventilation In Patients With AECOPD And Type Ⅱ Respiratory Failure

Objective:Type influence AECOPD combinedⅡrespiratory failure patients noninvasive ventilation treatment effect factors and common PACHEⅡgrade and CAPS on AECOPD combined typeⅡrespiratory failure patients noninvasive ventilation treatment effect of predictive value.Methods:A retrospective study was conducted to collect AECOPD patients with type II respiratory failure from January 2017 to April 2018 in the Second Affiliated Hospital of Anhui Medical University.114 patients were enrolled,and relevant clinical data were collected and scored on the APACHE II and CAPS rating scales.According to the treatment effect,it is divided into effective group and ineffective group.The difference between the two groups of patients and the scores of the two scores were compared.The ROC curve was used to analyze the predictive value of the two scores for the treatment of noninvasive ventilation.Results:1.Heart rate（t=-4.77,P<0.01）,Respiratory rate（t=-7.45,P<0.01）,Creatinine（t=-6.89,P<0.01）,Albumin（t=4.25,P<0.01）,Urea nitrogen（t=-8.02,P<0.01）,APACHEII（t=-7.95,P<0.01）,CAPS（t=-11.17,P<0.01）,K⁺（t=-2.07,P<0.05）,C-RP（t=-2.42,P<0.05）,PCT（t=-2.54,P<0.05）in the treatment effective group and the ineffective group were significantly different.After 2 hours of active treatment such as non-invasive ventilation,the Heart rate（t=7.31,P<0.01）,Respiratory rate（t=4.10,P<0.01）,and Arterial blood PH（t=-5.04,P<0.01）,PaCO₂（t=8.73,P<0.01）and Fingertip oxygen saturation（t=-3.08,P<0.01）were significantly different in the effective group,while the Heart rate of patients（t=2.11,P<0.05）,Fingertip oxygen saturation（t=-2.20,P<0.05）was significant in the ineffective group.Multivariate analysis showed respiratory rate（OR=2.10,95%CI 1.21³.64,P<0.05）,Creatinine（OR=1.05,95%CI 1.00¹.11,P<0.05）,PCT（OR=1.43,95%CI0.18¹1.60,P<0.05）,Urea nitrogen（OR=0.42,95%CI 0.18⁰.97,P<0.05）,Albumin（OR=0.78,95%CI0.52¹.16,P<0.05）,APACHEII（OR=2.54,95%CI 1.29⁵.02,P<0.05）,CAPS（OR=2.35,95%CI 1.12⁴.92,P<0.05）were related factors influencing the therapeutic effect of non-invasive ventilation in patients with AECOPD complicated with type II respiratory failure.2.The APACHE II score and CAPS score of the effective group were significantly lower than the ineffective group（P<0.01）,and the higher the score,the higher the failure rate of non-invasive ventilation treatment.The ROC curve analysis showed that the area under the APACHE II score and the CAPS score curve were 0.93 and 0.95（P<0.01）,and the Z test showed no significant difference in the predictive value of the two.The key point of the APACHE II score for judging noninvasive ventilation was>21,with sensitivity of 80%and specificity of 95%;CAPS score>At 25 points,the sensitivity was 93%and the specificity was 82%.Conclusions:1.Respiratory frequency,Creatinine,Urea nitrogen,PCT,Albumin,APACHE II score,and CAPS score were the relevant factors influencing the effective treatment of noninvasive ventilation in patients.2.APACHE II score and CAPS scoring system have good predictive value for the efficacy of non-invasive ventilation in patients with AECOPD complicated with type II respiratory failure,and there is no obvious difference between them.When the APACHE II score is>21 and the CAPS score is>25.The rate of non-invasive ventilation failure was higher in patients,and early invasive mechanical ventilation was recommended.