基于营养状态、SOFA及APACHE-II评分的心肺骤停患者复苏后死亡的列线图预测模型构建研究
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北京中医药大学东直门医院洛阳医院

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Analysis of the Predictive Value of SOFA, APACHE-II, Serum Amylase, PNI, and CAR for Mortality After Cardiopulmonary ResuscitationSi Jialei, Li Zhihui, Hu Yujing
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    摘要:

    目的 基于营养状态、序贯器官衰竭评分(SOFA)及急性生理与慢性健康状况评分系统II(APACHE-II)评分构建心肺骤停患者复苏后28d死亡的列线图预测模型。方法 选取2022年1月至2024年12月本院经心肺复苏术抢救成功的心脏骤停患者102例为研究对象,追踪其28d预后结局,58例死亡患者纳入死亡组(n=58),其他44例纳入存活组(n=44),收集患者的临床资料,并在复苏成功后24小时内完成SOFA、APACHE-II评分评估及血淀粉酶、PNI、CAR测定,比较死亡组与存活组患者上述指标差异,采用logistic回归模型分析心肺骤停患者复苏后28d死亡的影响因素,并基于SOFA、APACHE-II评分及血淀粉酶、PNI、CAR水平构建心肺骤停患者复苏后28d死亡的列线图预测模型。结果 死亡组患者SOFA、APACHE-II 评分及血淀粉酶、CAR水平均高于存活组,PNI指数低于存活组(P<0.05);组间白细胞计数、血小板计数及血红蛋白水平无差异(P>0.05)。经logistic回归分析显示,SOFA、APACHE-II评分及血淀粉酶、PNI、CAR水平均对患者复苏后28d死亡存在影响。基于SOFA、APACHE-II评分及血淀粉酶、PNI、CAR水平构建心肺骤停患者复苏后28d死亡的列线图预测模型,并经ROC曲线验证,该模型对患者复苏后28d死亡的预测AUC值为0.910(95%CI:0.847-0.973),具有较高的预测价值。结论 SOFA、APACHE-II评分及血淀粉酶、PNI、CAR水平均对心肺骤停患者心肺复苏后28d死亡存在影响,据此建立的列线图预测模型对心肺复苏后预后具有良好的预测效能。

    Abstract:

    Objective A nomogram prediction model of cardiopulmonary arrest patients was constructed based on nutritional status, sequential organ failure score (SOFA) and Acute Physical and Chronic Health Status scoring System II (APACHE-II). Methods Selected 102 cardiac arrest patients successfully rescued with CPR from January 2022 to December 2024 as the study subjects, Tracking its 28-d prognostic outcome, The 58 deceased patients were included in the death group (n=58), Other 44 patients were included in the survival group (n=44), To the clinical data of patients, SOFA, APACHE-II score assessment and determination of blood amylase, PNI and CAR within 24 hours after successful resuscitation, Comparing the differences between the death group and the surviving group, A logistic regression model was used to analyze the influencing factors of death 28d after resuscitation in cardiopulmonary arrest patients, A nomogram prediction model of death 28d after cardiopulmonary arrest was constructed based on SOFA, APACHE-II score, PNI and CAR level. Results The SOFA, APACHE-II scores, blood amylase and CAR levels were higher than the surviving group, and the PNI index was lower than the surviving group (P <0.05); there was no difference in leukocyte count, platelet count and hemoglobin level among the groups (P> 0.05). By logistic regression analysis, SOFA, APACHE-II score and blood amylase, PNI and CAR levels all affected the death 28d after resuscitation. The nomogram prediction model of death at 28d after cardiopulmonary arrest was constructed based on SOFA, APACHE-II score and the ROC curve and the predicted AUC value of 28d after resuscitation was 0.910(95%CI:0.847-0.973), which had a high predictive value.Conclusion SOFA, APACHE-II score and blood amylase, PNI and CAR levels all had effects on death 28d after cardiopulmonary resuscitation, so the established nomogram prediction model had good predictive efficacy on prognosis after cardiopulmonary resuscitation.

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司佳蕾.基于营养状态、SOFA及APACHE-II评分的心肺骤停患者复苏后死亡的列线图预测模型构建研究[J].四川生理科学杂志,2026,48(1):

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  • 收稿日期:2025-04-01
  • 最后修改日期:2025-07-05
  • 录用日期:2025-07-23
  • 在线发布日期: 2026-01-23
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