PIRO评分对急诊室社区获得性肺炎无创正压通气治疗失败的预测意义

doi:10.3969/j.issn.1002-1949.2019.06.012

摘要
图/表
参考文献(12)
相关文章 (5)

全文: PDF (870 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨PIRO评分对急诊室社区获得性肺炎(CAP)患者无创正压通气(NPPV)治疗失败的预测价值。方法对122例行NPPV的急诊室CAP患者进行回顾性分析，分别计算PIRO、SMART-COP、CURB-65和IDSA/ATS次要标准的评分，根据NPPV治疗的结局，使用受试者工作特征曲线(ROC曲线)，计算四种评分的曲线下面积(AUC)，PIRO评分与SMART-COP、CURB-65和IDSA/ATS次要标准评分之间的AUC进行比较。结果 PIRO、SMART-COP、CURB-65和IDSA/ATS次要标准四种评分在NPPV治疗成功组和NPPV治疗失败组比较差异有统计学意义（P<0.01），其预测CAP患者NPPV治疗失败的AUC分别为0.804、0.746、0.639和0.762。PIRO评分与SMART-COP、IDSA/ATS评分的 AUC比较差异无统计学意义(P>0.05)，PIRO评分与CURB-65评分的AUC比较差异有统计学意义（0.804 vs.0.638,P<0.05）。结论 PIRO评分对急诊室CAP 患者NPPV治疗失败有较好的预测价值，PIRO评分比CURB-65评分更具有优势。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	朱永城
	江慧琳
	陈晓辉
	莫均荣
	伍卓文
	冯雪珍
	林珮仪

关键词 ：社区获得性肺炎(CAP), 无创正压通气（NPPV), PIRO评分, SMART-COP评分, CURB-65评分, IDSA/ATS次要标准评分

基金资助:广东省科技计划项目（2014B02012013）；广州市医学重点学科建设项目（2017-2019年）

通讯作者: 林珮仪（1966-），女，主任医师，急诊科主任，教授，E-mail:linpeiyi@163.com。

作者简介: 朱永城（1982-），男，博士，主治医师，E-mail:zycgyey_2006@126.com。

引用本文:

朱永城，江慧琳，陈晓辉，莫均荣，伍卓文，冯雪珍，林珮仪. PIRO评分对急诊室社区获得性肺炎无创正压通气治疗失败的预测意义[J]. 中国急救医学, 2019, 39(6): 578-582.
Zhu Yong-cheng, Jiang Hui-lin, Chen Xiao-hui, Mo Jun-rong, Wu Zhuo-wen, Feng Xue-zhen, Lin Pei-Yi. Predictive value of PIRO score for the non-invasive positive ventilation failure in emergency department patients with community acquired pneumonia. Chinese Journal of Critical Care Medicine, 2019, 39(6): 578-582.

链接本文:

http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.06.012 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I6/578

［1］Nava S， Hill N.Non-invasive ventilation in acute respiratory failure［J］. Lancet, 2009, 374(9685)：250-259. ［2］Valley TS, Walkey AJ, Lindenauer PK, et al. Association between noninvasive ventilation and mortality among older patients with pneumonia［J］. Crit Care Med, 2017, 45(3):e246-e254. ［3］Mehta AB, Douglas IS, Walkey AJ. Evidence-based utilization of noninvasive ventilation and patient outcomes［J］. Ann Am Thorac Soc, 2017, 14(11): 1667-1673. ［4］Howell MD, Talmor D, Schuetz P, et al. Proof of principle: the predisposition, infection, response, organ failure sepsis staging system［J］. Crit Care Med, 2011, 39(2):322-327. ［5］Rello J, Rodriguez A, Lisboa T, et al. PIRO score for community acquired pneumonia: a new prediction rule for assessment of severity in intensive care unit patients with community-acquired pneumonia［J］. Crit Care Med, 2009, 37(2):456-462. ［6］Lisboa T, Diaz E, Sa-Borges M, et al. The ventilator-associated pneumonia PIRO score: a tool for predicting ICU mortality and health-care resources use in ventilator-associated pneumonia［J］. Chest, 2008, 134 (6):1208-1216. ［7］Nicolini A, Ferraioli G, Ferrari-Bravo M, et al. Early non-invasive ventilation treatment for respiratory failure due to severe community-acquired pneumonia［J］. Clin Respir J, 2016, 10(1):98-103. ［8］Murad A, Li PZ, Dial S, et al. The role of noninvasive positive pressure ventilation in community-acquired pneumonia［J］. J Crit Care, 2015, 30(1):49-54. ［9］Stefan MS, Priya A, Pekow PS, et al. The comparative effectiveness of noninvasive and invasive ventilation in patients with pneumonia［J］. J Crit Care, 2018,43: 190-196. ［10］Marshall JC. The PIRO(predisposition, insult, response, organ dysfunction) model: toward a staging system for acute illness［J］. Virulence, 2014, 5(1):27-35. ［11］Mcdonald SP， Arendts G， Fatovich DM， et al． Comparison of PIRO， SOFA， and MEDS scores for predicting mortarity in emergency department patients with severe sepsis and septic shock［J］． Acad Emerg Med, 2014, 21(11):1257-1263. ［12］Quinten VM, van Meurs M, Wolffensperger AE, et al. Sepsis patients in the emergency department: stratification using the clinical impression score, predisposition, infection, response and organ dysfunction score or quick sequential organ failure assessment score［J］． Eur J Emerg Med, 2018, 25（5）:328-334.