頁籤選單縮合
題 名 | 加護病房胸腔病患預後指標的選擇=Selection of Prognosis Index for Chest Patients in Intensive Care Unit |
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作 者 | 趙崇良; 李世偉; 賴敏謙; | 書刊名 | 內科學誌 |
卷 期 | 8:1 1997.03[民86.03] |
頁 次 | 頁46-51 |
分類號 | 419.39 |
關鍵詞 | 急性生理, 年齡, 慢性健康評估; 治療介入得分系統; 獨立狀態及人口統計變數; 狀態參數得分; 加護病房護理需求; Acute physiology, age, chronic health evaluation; Therapeutic intervention scoring system; Condition index score; Discrete condition and demographic variables; Intensive care nursing requirements; |
語 文 | 中文(Chinese) |
中文摘要 | 目前加護病房病患嚴重度的評估常用的有 acute physiology, age, chronic health evaluation (APACHE), therapeutic intervention scoring system (TISS), condition index score (CIS), discrete condition and demographic variables (DCDV) 及 intensive care nursing requirements (ICNR) 五種量表。本研究的目的是由這五種中 找出那一種最適合做加護病房胸腔病患的預後指標 (prognosis index)。 APACHE 用 1985 年出版的 APACHE II 算得分, TISS 用 1983 年出版的 TISS-1983 算得分,CIS 只取呼吸 項目 (CIS-res) 算總合,DCDV 分別測入院時 (DCDV- adm) 及 24 小時後 (DCDV-24hr) 算 總合,ICNR 由入院 24 小時內量化的加護病房護理工作算得分。 APACHE II 得分又可和診 斷分類加權指數 (diagnostic category weight) 算出總合。 然後我們可由 APACHE II, DCDV-adm 及 DCDV-24hr 三種量表的總合,用公式 R=exp (sum)/(1+exp(sum)) 求得各種量 表的死亡危險率 (APACHE II(R), DCDV-adm (R) 及 DCDV-24hr(R))。 我們以 1995 年一整 年內進入省立桃園醫院成人內外科加護病房且以胸腔疾病為主診斷的病人為研究對象。病人 可歸屬全部病患,內科病患,外科病患,高齡病患及內科高齡病患五樣本。計算每位病患的 各項量表值並記錄最後轉歸 (outcome),統計每個樣本內存活組對死亡組各項量表值。結果 顯示 DCDV-24hr 總合在所有樣本內兩種轉歸間的差別皆有統計意義。 CIS-res 總合、 APACHE II(R) 及 DCDV-24hr(R) 在全體胸腔病患及外科胸腔病患樣本內兩轉歸間的差別也 有統計意義。 其它評估評估量表除 APACHE II 在外科病患的計算以外皆沒有統計意義。這 些資料暗示 DCDV-24hr 總合為加護病房胸腔病患最有效的預測量表, CIS-res 總合、 APACHE II(R) 及 DCDV-24hr(R) 也是好的預後指標。 |
英文摘要 | Acute physiology, age, chronic health evaluation (APACHE), therapeutic intervention scoring system (TISS), condition index score (CIS), discrete condition and demographic variables (DCDV) , and intensive care nursing requirements (ICNR) five contemporary measurements Have developed to evaluate the severity of illness for intensive care unit (ICU) patients. This paper is designed to select a potentially reliable prognosis index for chest patients in ICU. In this study, the APACHE II, published in 1985, and the TISS-1983, published in 1983, were employed, Only respiratory items listed in the CIS (CIS-res) were assessed. Data at admission (DCDV-adm) and after 24 hours in the ICU (DCDV-24hr) were collected respectively in the measurement of the DCDV. The ICNR quantified nursing care requirements within the previous 24 hours in the IC U. In addition, a sum of the APACHE II was determined by the APA-CHE II score and the reference on a diagnostic category weight. Then, from the sum of the APACHE II, DCDV-adm, and DCDV-24hr, we formulated the mortality risk estimate (APACHE II(R), DCDV-adm(R) and DCDV-24hr(R)) yb the following equation: risk = exp(sum)/(1 + exp(sum)). The patients admitted to the adult medical and surgical ICU of Taiwan Provincial Taoyuan General Hospital in 1995 with a primary diagnosis of chest disease were enrolled in this study. Individaul patients were allocated into the sample of total patients, the sample of medical patients, the sample of surgical patients, the sample of geriatric patients and the sample of geriatric medical patients five categories. We calculated each patient's measurement values and recorded the outcome. The significance of the difference of the commensurate values between survivor and non-survior outcome groups was tested. Our finding was that the DCDV-24hr sum difference was demonstrated significant between the two different outcome groups in all samples. There were also significant CIS-res sum, APACHE II(R) and DCDV-24hr(R) differences between the two outcome groups in the sample of all patients and the sample of surgical patients. Other measurements failed to achieve statistical significance except APACHE II in the sample of surgical patients. These data indicated that the DCDV-24hr sum was the most efficient predictor which the patients placed in chest ICU would most benefit. The CIS-res sum, APACHE II(R) and DCDV-24hr(R) also provided validated estimates. |
本系統中英文摘要資訊取自各篇刊載內容。