The Relationship Of APACHEII Score To Serum Prealbumin And Lipid Levels In Critically Ill Patients

Objective To explore the relationship between acute physiology and chronic health evaluation II score(APACHEII) and serum prealbumin and lipid levels,and study the effect of serum prealbumin and lipid levels on prognosis and condition of critically ill patients admitted to EICU(emergent intensive care unit) within the first 24 hours.Methods Forty-eight critically ill patients admitted to EICU were selected. Blood samples were drawn within the first 24 hours after admission.Serum prealbumin (SPAB) levels were detected by immune scattery radio nephelometry,and automatic biochemical machine was employed to determine the serum total protein(TP),albumin (ALB),triglyceride(TG), total cholesterol(TC),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol(LDL-C). At the same time,APACHEII score was introduced to evaluate the severity of forty-eight critically ill patients. All of the patients were divided into two groups:group I including twenty-one patients (APACHEII score≥20) and group II including twenty-seven patients (10≤APACHEII score<20).At the same time, all of the patients were divided into two groups according to the patients'prognosis in the following two weeks:the death group(fifteen patients) and the survival group (thirty-three patients).These data were analyzed with SPSS14.0.Results The patients in group I had significantly higher APACHEII score than those in group II(P<0.05).The serum PAB,TC and HDL-C levels in group I were lower than those in groupII (P<0.05).The death group had significantly higher APACHEII score than those in the survival group(P<0.05). The serum PAB and HDL-C levels in the death group were lower than those in the survival group(P<0.05).A negative correlation was found between APACHEII score and PAB,TC and HDL-C levels.A positive correlation was found between PAB and TC,HDL-C and LDL-C levels.Conclusion The critically ill patients were prone to develop the low serum prealbumin and low serum lipid levels. There is a negative correlation between APACHEII and sPAB and lipid levels at initial stage of critical illness.It could be better to predict the prognosis and to judge the severity of critically ill patients to combine the serum PAB and lipid levels with APACHEII score than to use APACHEII score only.At the same time,it could be beneficial to measure the levels of serum PAB and lipid at initial stage of critical illness in treating critically ill patients.