摘要
目的 比较ABC(年龄、血液学、合并症)评分、AIMS65评分、格拉斯哥-布拉奇福德评分(GBS)预测急性上消化道出血(AUGIB)病人死亡方面的表现。方法 回顾性收集2018年12月至2022年1月于徐州医科大学附属医院确诊为AUGIB的330例病人资料,根据病人住院期间的生存情况,分为存活组(304例)和死亡组(26例)。收集病人的一般资料和实验室检查结果,进行ABC、AIMS65和GBS,评估3种评分对AUGIB病人住院死亡的预测能力。结果 两组病人的年龄、血清白蛋白(ALB)、国际标准化比值(INR)、ABC评分、AIMS65评分、GBS及有无吸烟、恶性肿瘤、心衰、黑便、晕厥等的比较差异有统计学意义(P<0.05)。与存活组相比,死亡组病人的ABC评分[9.50(7.50,12.00)比3.00(2.00,5.00)]、AIMS65评分、GBS、INR[1.53(1.16,1.90)比1.03(0.96,1.16)]显著升高(P<0.05)。logistic回归分析显示ALB、INR、ABC评分是AUGIB病人住院死亡的独立危险因素。ROC曲线显示三种评分对AUGIB病人住院死亡均有一定预测价值,ABC评分预测住院死亡的价值较高,AUC 95%CI为0.90(0.87,0.94)、P<0.001,灵敏度为84.6%,特异度为90.5%;AIMS65评分和GBS具有中等预测价值,AUC 95%CI分别为0.84(0.80,0.88)、P<0.001,0.82(0.78,0.86)、P<0.001,灵敏度分别为76.9%、69.2%,特异度分别为81.6%、87.8%。结论 ABC评分对AUGIB病人住院死亡的预测价值较好,AIMS65评分和GBS的预测价值中等。
Objective To compare the predictive value of ABC,AIMS65 and GBS scores on the death of patients with Acute Upper Gas-trointestinal Bleeding(AUGIB).Methods Three hundred and thirty patients with AUGIB diagnosed in the Affiliated Hospital of Xuzhou Medical University from December 2018 to January 2022 were retrospectively selected.The patients were assigned into survival group and death group according to their survival during hospitalization.Then patients′general information and laboratory examination results were collected,and the ABC score,AIMS65 score and GBS score of the two groups were calculated.The predictive value of three scores on the in-hospital death of AUGIB patients was estimated.Results Among the 330 AUGIB patients,304 were survived and 26 were died.There were significant differences in age,ALB,INR,ABC score,AIMS65 score,GBS score,smoking,malignant tumor,heart failure,me-lena and syncope between the two groups(P<0.05).Compared with the survival group,the ABC scores[9.50(7.50,12.00)vs.3.00(2.00,5.00)],AIMS65 scores,GBS scores,and INR[1.53(1.16,1.90)vs.1.03(0.96,1.16)]in the death group were significantly increased(P<0.05).Logistic regression analysis showed that ALB,INR and ABC scores were independent risk factors for the hospital death of patients with AUGIB.The ROC curve showed that three scores had predictive value of the hospital death of patients with AUGIB.ABC score had a higher predictive value of the hospital death of patients with AUGIB,the AUC 95%CI value of ABC was[0.90(0.87,0.94),P<0.001],the sensitivity value was 84.6%,and the specificity value was 90.5%;AIMS65 score and GBS score had moderate predictive value,the AUC 95%CI values of AIMS65 score and GBS score were[0.84(0.80,0.88),P<0.001]and[0.82(0.78,0.86),P<0.001],the sensitivity values were 76.9%and 69.2%,the specificity values were 81.6%and 87.8%,respectively.Conclusion ABC score has high predictive value of hospital death of patients with AUGIB,and AIMS65 score and GBS score have moderate predictive value.
作者
吴娜娜
吴克俭
WU Nana;WU Kejian(Graduate College of Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Gastroenterology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221006,China)
出处
《安徽医药》
CAS
2024年第4期809-812,共4页
Anhui Medical and Pharmaceutical Journal
