摘要目的 探讨用急诊重症加强治疗病房(EICU)患者急性生理学与慢性健康状况评分系统 Ⅱ(APACHEⅡ)评分预估护理工作量的价值.方法 回顾性分析2012年6月至2016年7月四川大学华西医院EICU收治的非创伤危重患者的临床资料,选择其中同时进行了APACHEⅡ 评分和常用ICU护理工作量评估方法的治疗干预评分系统(TISS-28)评分的患者为研究对象,通过相关分析与曲线估计法,分析APACHEⅡ 评分与TISS-28评分的关系.结果 共纳入1148例患者,其中男性689例(占60.0%),年龄(56±19)岁,APACHEⅡ 评分19(13,25)分,TISS-28评分19(13,25)分.Spearman相关分析显示,APACHEⅡ 评分与TISS-28评分呈显著正相关(r=0.849,P<0.001).用线性曲线模型、二次项曲线模型、三次项曲线模型、复合曲线模型、增长曲线模型和指数曲线模型评估APACHEⅡ 评分与TISS-28评分的曲线关系显示,R2值分别为0.669、0.710、0.792、0.764、0.765、0.765(均P<0.01),其中最适合描述二者曲线关系的是三次项曲线模型.当APACHEⅡ 评分≥30分时,护理工作量明显增加;而当APACHEⅡ 评分<30分时,护理工作量相对变少.结论 EICU患者的APACHEⅡ 评分可用于预估护理工作量.

abstractsObjective To investigate the predictive value of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) for nursing workload in emergency intensive care unit (EICU).Methods A retrospective cohort study was conducted. Critical patients except for trauma admitted to EICU of West China Hospital of Sichuan University from June 2012 to July 2016 were enrolled. APACHE Ⅱ score and therapeutic intervention scoring system (TISS-28) score were calculated in each case. The relationship between APACHE Ⅱ score and TISS-28 score was analyzed by correlation analysis and curve estimation.Results A total of 1148 patients were enrolled, including 689 male (60.0%), and age of (56±19) years old, APACHE Ⅱ score was 19 (13, 25), and TISS score was 19 (13, 25). The Spearman correlation coefficient between APACHE Ⅱ score and TISS-28 score was 0.849 (P < 0.001), and that among the linear model quadratic model, composite model, growth model, logarithm model, cubic model and exponential modelR2 were 0.669, 0.710, 0.792, 0.764, 0.765, 0.765, respectively (allP < 0.01), and the most suitable description for relationship between APACHE Ⅱ score and TISS-28 score curve was cubic model. The nursing workload was significantly increased when APACHE Ⅱ score ≥30, and it was decreased when APACHE Ⅱ score < 30.Conclusion APACHE Ⅱ was a useful score for predicting the nursing workload in EICU.