Prognostic value of APACHE Ⅱ and CAPS score in patients with AECOPD combined with respiratory failure / 中国基层医药

ABSTRACT

Objective To evaluate the prognostic value of acute physiology and chronic health status score (APACHE Ⅱ) and chronic obstructive pulmonary disease (COPD) and bronchial asthma physiology score (CAPS) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure.Methods From February 2016 to January 2018,139 patients with AECOPD complicated with type Ⅱ respiratory failure in the Second People's Hospital of Lishui were selected.APACHE Ⅱ and CAPS were scored on the day of admission.The patients were divided into survival group (97 cases) and death group (42 cases) according to their clinical prognosis.Results The APACHE Ⅱ score and CAPS score of the death group were significantly higher than those of the survival group at admission [(20.15 ± 3.27) points vs.(23.84 ± 2.18) points,(30.85 ± 3.44) points vs.(34.46 ± 5.72) points,t =5.601,4.596,all P ＜ 0.05].The higher the score of APACHE Ⅱ and CAPS,the higher the fatality rate of patients (69.77％ vs.12.50％,58.33％ vs.15.38％) (x2 =46.190,27.490,all P ＜ 0.05).The AUC of APACHE Ⅱ score predicted death in patients with AECOPD and respiratory failure was 0.916 with high accuracy.The AUC of CAPS score predicted the death rate of patients with AECOPD combined with respiratory failure was 0.846,and the prediction had certain accuracy.Conclusion APACHE Ⅱ score and CAPS score have good clinical application value in evaluation of prognosis of patients with AECOPD complicated with respiratory failure.APACHE Ⅱ score is more effective in predicting the death of patients.The combination of APACHE Ⅱ score and CAPS score can be considered in clinical application,which can help doctors to draw up the best treatment plan and improve the clinical prognosis of patients.