MODS score on prognostic evaluation of elderly patients with multiple organ dysfunction syndrome

doi:10.3877/cma.j.issn.1674-6902.2020.02.012

Abstract

Abstract:

Objective

To compare the prognostic values of revised multiple organ dysfunction score (MODS) and the current scoring systems for elderly patients with multiple organ dysfunction syndrome (MODSE).

Methods

The first 24-hour data of 387 patients with MODSE after admission to the Intensive Care Unit in the General Hospital of Chinese People′s Liberation Army from January 2015 to December 2018 were analyzed retrospectively. Then the prognostic effectiveness of each scoring system, including acute physiological and chronic health status scores (APACHE Ⅱ, APACHE Ⅲ), simplified acute physiology score (SAPS Ⅱ), MODS score, MODS combined age score, MODS combined age double score, MODS combined age index revised score, were evaluated and tested.

Results

Compared with the female group, the average length of ICU stay and the average age of death were significantly lower, and the 28-day mortality and the overall mortality were higher in the male group (P<0.05). With the age increasing, the number of organ failure, the 28-day mortality and the overall mortality gradually increased, and the average length of stay in ICU gradually decreased. Compared with the survival group, the average age and the scores of the death group increased significantly. The areas under the ROC curve of these 7 scoring systems were 0.810, 0.791, 0.712, 0.801, 0.834, 0.787 and 0.793, respectively. Compared with the above scoring systems, APACHE Ⅱ had the best performance in specificity while MODS combined age score had the highest sensitivity and its Youden index and the area under the ROC curve were the largest.

Conclusion

Revised MODS and the existing score systems can evaluate the prognosis of the patients with MODSE at the early stage. Among them, MODS combined with age score system has better prognostic evaluation efficiency.

Key words: Elderly, Multiple organ dysfunction syndrome, Scoring system, Age score, Prognosis

Kun Xiao, Chao Guo, Jishou Ruan, Peng Yan, Lixin Xie. MODS score on prognostic evaluation of elderly patients with multiple organ dysfunction syndrome[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(02): 183-187.

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References 31

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分　组	衰竭器官数目	住ICU时间(d)	28 d病死率(%)	总体病死率(%)
65～74岁	3.31±1.27	24.91±24.48	45.05(41/91)	53.75(48/91)
75～84岁	3.61±1.18	23.88±23.94	48.03(73/152)	59.21(90/152)
85～90岁	3.65±1.10	18.89±17.57	50.00(56/112)	59.82(73/112)
≥91岁	3.72±1.17	16.56±14.78	53.12(17/32)	71.88(23/32)

分　组	衰竭器官数目	住ICU时间(d)	28 d病死率(%)	总体病死率(%)
65～74岁	3.31±1.27	24.91±24.48	45.05(41/91)	53.75(48/91)
75～84岁	3.61±1.18	23.88±23.94	48.03(73/152)	59.21(90/152)
85～90岁	3.65±1.10	18.89±17.57	50.00(56/112)	59.82(73/112)
≥91岁	3.72±1.17	16.56±14.78	53.12(17/32)	71.88(23/32)

分　组		年龄	APACHE Ⅱ	APACHE Ⅲ	SAPS Ⅱ	MODS	MODS1	MODS2	MODS3
28天生存		75.57±9.24	19.17±6.63	70.18±23.07	45.82±16.89	6.57±2.58	7.51±3.01	10.17±4.24	8.63±3.89
28天死亡		84.05±8.77	27.92±7.90	100.43±28.41	59.16±18.60	11.33±4.35	13.08±4.96	14.82±4.61	13.32±4.52
	P值	0.015	0.010	0.009	0.013	0.000	0.000	0.027	0.000

分　组		年龄	APACHE Ⅱ	APACHE Ⅲ	SAPS Ⅱ	MODS	MODS1	MODS2	MODS3
28天生存		75.57±9.24	19.17±6.63	70.18±23.07	45.82±16.89	6.57±2.58	7.51±3.01	10.17±4.24	8.63±3.89
28天死亡		84.05±8.77	27.92±7.90	100.43±28.41	59.16±18.60	11.33±4.35	13.08±4.96	14.82±4.61	13.32±4.52
	P值	0.015	0.010	0.009	0.013	0.000	0.000	0.027	0.000

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