APACHE Ⅱ Score Combined With Arterial Lactate Clearance Rate And Procalcitonin To Judge The Prognosis Of Severe Pneumonia

Objectives To study the prognostic value of APACHE II score combined with arterial lactate clearance and procalcitonin in patients with severe pneumonia.Methods From October 2019 to December 2020,50 patients with severe pneumonia were diagnosed in the Department of intensive Medicine of North China University of Technology.According to the survival of 28 days,the patients were divided into survival group(25 cases)and death group(25 cases).Collect general data,age,sex,multiple organ dysfunction(MODS situation and Emergency situation.To calculate admission APACHE II,24 h APACHE II,48 h APACHE II,monitoring P-CT values within 24 hours of admission,lactate at admission,Lactate 24 hours(24h Lac),Lactic acid 48 hours(48h Lac).And calculated 24 hours lactate clearance(24h LCR)according to the recorded lactic acid value,48 hours lactate clearance(48h LCR).Analysis of general data by chisquare test or t two independent samples.Comparison of survival and death groups two independent samples admission APACHE II score,24 h APACHEII score,48 h APACHE II score,PCT admission,admission Lac,24 h Lac,48 h Lac,48 h LCR.The receiver operating characteristic(ROC)curve was established and the area under the curve(AUC) was calculated to analyze the value of above single index in evaluating the prognosis of patients with severe pneumonia and APACHE II score combined with arterial blood lactate clearance rate or procalcitonin to judge the prognosis of severe pneumonia.Results 1 There was no significant difference in sex and age composition between the two groups(P>0.05).There were significant differences in MODS rate,rescue rate and hospitalization days between the two groups(P<0.05).MODS incidence,rescue rate and hospitalization days in survival group were lower than those in death group.2 There was no significant difference Lac,24 h Lac,48 h Lac survival group and death group on admission.The scores of admission PCT,admission APACHE II,24 h APACHE II and 48 in survival group were lower than those in death group.Survival group 24 h LCR,48 h LCR higher than death group,the difference was statistically significant(P<0.05).3 ROC analysis results:The AUC values of admission APACHE II score,24 h APACHE II score and 48 h APACHE II score were 0.779,0.801,0.854;The AUC values of Lac,24 h Lac,48 h Lac,24 h LCR,48 h LCR were 0.481,0.620,0.693,0.734,0.851;The AUC value of admission PCT is:0.741.The AUC values of Admission APACHE II score combined admission Lac,Admission APACHE II score combined admission PCT,admission APACHE II score combined with admission Lac and admission PCT were:0.777,0.781,0.768;The AUC values of 24 h APACHE II score combined with 24 h Lac,24 h APACHE II score combined with 24 h LCR,24 h APACHE II score were:0.794,0.802,0.828,0.829;The AUC values of 48 h APACHE II score combined with 48 h Lac,48 h APACHE II score combined with 48 h LCR,48 h APACHE II score were:0.855,0.856,0.939,0.950.Conclusions 1 The value of lactic acid in admission APACHE II score combined with admission was not better than that in APACHE II score.2 The value of APACHE II score combined with LCR in judging prognosis of patients with severe pneumonia>APACHEII score combined with PCT>APACHE II score combined with Lac.3 The prognostic value of APACHE II score combined with LCR and or PCT is better than that of the above three indexes.Figure 6;Table 7;Reference 110...