Comparison Of ApacheⅡand SOFA Score In Prognostic Evaluation On Patients Wan Sepsis

Objective:To evaluate the prognostic value of APACHEⅡ score and SOFA score in patients with sepsis.Methods:Retrospective studies,69 patients who were admitted to ICU of Gaotang People’s Hospital from October 2012 to May 2013 were selected.APACHEⅡ score,SOFA initial score(the worst score in the first 24 hours of ICU)and SOFA high score(the worst score in 72 hours of ICU)were performed,and the 28-day outcome was recorded.APACHEⅡ score and SOFA score of patients with different prognosis were compared by variance analysis and covariance analysis;different prognosis and different patients’ score were compared by＿2 test trend;Pearson correlation and Kappa value were used to compare the correlation and consistency of the two scores;and the main scoring system that affected the prognosis of patients was analyzed by logistic regression analysis;and the working characteristic curve of subjects was used to compare the two scoring systems.Linear analysis and comparison of APACHEⅡ score,SOFA initial score and SOFA high value score on the prognosis of patients with sepsis evaluation and advantages and disadvantages.Result:1.Sixty-nine patients with sepsis survived for 28 days and 23 died.According to the prognosis,they were divided into survival group(46 cases)and death group(23 cases).The average age of survival group was(62.86 + 16.78)years,which was higher than that of death group(51.51+17.91).There was significant difference in the average age between the two groups(P<0.05).The APACHEⅡ score,SOFA initial score and SOFA high score of the dead group were higher than those of the surviving group(P<0.01).69 patients were divided into elderly group(37 cases)and middle-aged group(32 cases),while the mortality rate of the elderly group was 50.00%,higher than 18.92% of the young and middle-aged group(P<0.05).The APACHEⅡ score of the elderly group was higher than that of the young and middle-aged group(P<0.05).There was no significant difference in the initial SOFA score and the high SOFA score between the two groups(P>0.05).Using two-factor variance analysis without considering interaction,the results showed that APACHEⅡ score had significant difference among different age groups and different prognosis groups(all P<0.05);initial SOFA score and high SOFA score had significant difference among different prognosis groups(all P<0.05),and there was no significant difference among different age groups(all P<0.05).2.Pearson correlation coefficients between APACHEⅡ score,initial SOFA score and high SOFA score were 0.733 and 0.645,respectively,while Pearson correlation coefficients between initial SOFA score and high SOFA score were 0.876,with statistical significance(P<0.01).The Kappa value of APACHEⅡ score and SOFA initial score was 0.345,and the Kappa value of APACHEⅡ score and SOFA high score was 0.233.The mortality rate increased with the increase of APACHEⅡ score,and the trend was statistically significant(2 trends = 4.641,P = 0.031).The mortality rate was different in different grades of SOFA.With the increase of initial SOFA score and high SOFA score,the mortality rate tended to increase(P<0.05).3.Regarding the prognostic mortality and survival rate as dependent variables,using the initial score of SOFA,the high value score of SOFA and APACHEⅡ as independent variables,logistic regression analysis was carried out.Finally,the high value score of SOFA entered the equation.The high value score of SOFA was the main scoring system to evaluate the prognosis of patients.The area under the ROC curve of APACHEⅡ score,SOFA initial score and SOFA high score were(0.739(+0.065),(0.724(+0.071)and(0.773(+0.067),respectively,with statistical significance(P<0.01).From the area under ROC curve,SOFA high score is better than APACHEⅡ score in predicting the prognosis of sepsis patients,but the difference is not statistically significant.The maximum critical values of APACHEⅡ score,SOFA initial score and SOFA high score were 24.5,12.0 and12.0,respectively.From the ROC curve,the sensitivity of APACHEⅡ score was better than that of SOFA initial score and SOFA high score,while the specificity of SOFA initial score and SOFA high score was better than that of APACHEⅡ score.Conclusion:1.The APACHEⅡ score and SOFA score were different in sepsis patients with different prognosis.The APACHEⅡ score,the initial SOFA score and the high SOFA score were higher in sepsis death group,and the APACHEⅡ score in elderly patients was higher than that in young and middle-aged patients.2.The correlation between APACHEⅡ score and SOFA initial score and SOFA high value score is high,but the consistency is low.The higher the APACHEⅡ score and SOFA score,the higher the mortality rate.3.APACHEⅡ score,SOFA preliminary score and SOFA high value score all play a certain role in the prognosis evaluation of sepsis patients.APACHEⅡ score is more sensitive than SOFA preliminary score and SOFA high value score,while the specificity of SOFA preliminary score and SOFA high value score is better than APACHEⅡ score.Therefore,the combination of SOFA score and APACHEⅡ score may be more valuable in evaluating the prognosis of sepsis patients.