目的 比较第三代小儿死亡危险评分(pediatric risk of mortality III score, PRISM III)和新生儿危重病例评分(neonatal critical illness score, NCIS)在预测危重新生儿死亡风险方面的优越性, 探讨更适合我国NICU应用的评分系统。方法 对2013年1-6月入住新疆石河子大学第一附属医院新生儿重症监护室(neonatal intensive care unit, NICU)的135例患儿同时采用NCIS和PRISM III两种评分系统进行评分, 根据评分将入组病例分为极危重、危重、非危重3组, 分别对各组病死率进行比较, 并描绘受试者工作特征曲线(receiver operating characteristic curve, ROC), 比较ROC曲线下面积(area under the ROC curve, AUC), 以观察两种评分系统在预测危重新生儿死亡风险的优越性。结果 NCIS评分与PRISM III评分非危重组、危重组与极危重组组间病死率比较, 差异均有统计学意义(P＜0.05);两种评分对应组组间比较, 差异均无统计学意义(P＞0.05);AUC:NCIS评分0.900, PRISM III评分0.909。结论 NCIS评分与PRISM III评分均能准确预测新生儿死亡风险, PRISM III评分在我国完全适用。
Abstract
Objective To compare the advantages of critically ill neonates mortality risk prediction between neonatal critical illness score (NCIS) and pediatric risk of mortality score and to research for the better neonatal disease severity scoring system feasible for use in our country.Methods The 135 neonates, who were in neonatal intensive care unit（NICU）from January 2012 to June 2013 in the first Hospital Affiliated to Shihezi University, were scored by NCIS and pediatric risk of mortalityⅢ (PRISM Ⅲ).According to the simultaneously scores the patients were divided into three groups（very critical group, critical group, non-critical group）, and mortality rates were compared in each group.At the same time the receiver operating characteristic curve（ROC） was drawn and counted out their areas under the ROC curves (AUC) to observe the specificity and sensitivity of two scoring systems in predicting the risk of death in critically ill neonates.Results The comparison between NCIS and PRISM III score:the differences were statistically significant in mortality among the noncritical, the critical and the very critical groups（P all ＜0.05）;the differences were not statistically significant in mortality among the non-critical, the critical and the very critical subgroups（P all ＞0.05）;AUC:NCIS 0.900, PRISM III 0.909.Conclusion Both NCIS and PRISM III can predict mortality risk in critically ill neonates, PRISM III is fully applicable in China.
关键词
新生儿危重病例评分 /
第三代小儿死亡风险评分 /
死亡风险
Key words
neonatal critical illness score /
pediatric risk of mortality III score /
mortality risk
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