log ey / 1 - Y = - 7. 275 + 0. 245

121 2000 1 2008 7 311 239 72 APACHE t logistic 18 ph GCS log ey / 1 - Y = - 7. 275 + 0. 245 Establishing a prediction system for the critically ill obstetric patients KUANG Jian-luan LIU Hui-shu CHEN Dun-jin ZHENG Zheng HUANG Tian-qing HUANG Dong-jian. Department of Obstetrics the Third Affiliated Hospital of Guangzhou Medical University Guangzhou 510150 China Corresponding author LIU Hui-shu Email huisuliu@ hotmail. com Abstract Objective To establish a prediction system for the critically ill obstetric patients. Methods A retrospective study was conducted in 311 critically ill obstetric patients who were admitted to the ICU of the Third Affiliated Hospital of Guangzhou Medical University from January 2000 to July 2008. The patients were divided into dead group 72 patients and survival group 239 patients. Assigned the clinical indexes related to the mortality and established a prediction system for the critically ill obstetric patients. The clinical indexes were analyzed by using t test and the mortality prediction equation by using logistic regression model. Results The prediction system involved 18 clinical indexes including body temperature mean artery pressure respiratory rate heart rate PaO 2 /FiO 2 arterial ph serum sodium serum potassium blood glucose serum creatinine serum total bilirubin serum albumin ALT blood platelet count fibrinogen white blood count hematocrit and scores of nervous system. The prediction equation for the mortality risk log ey / 1 - Y = - 7. 275 + 0. 245 total scores. Conclusions Establishing a prediction system for the critically ill obstetric patients not only improves the diagnostic level but also has an scientific and objective basis in improving medical quality and utilizing the medical resources. Key words Pregnancy high-risk Severity of illness index Forecasting Evaluation DOI 10. 3877 /cma. j. issn. 2095-3259. 2013. 02. 009 2012B031800335 510150 Email huisuliu@ hotmail. com 1-2

122 0. 05 < P < 0. 1 34 3-8 acute physiology and chronic health evaluation scoring system APACHE APACHEⅡ APACHEⅢ 1-2 18 17 4 APACHEⅡ APACHEⅢ 0 ~ 4 APACHE ALT 3 18 15 GCS GCS 15 3 0 ~ 78 intensive care unit ICU 311 239 72 ICU 24 h logistic logistic 2000 1 2008 7 311 239 72 SPSS 13. 0 ± x 珋 ± s t 34 logistic P < 0. 05 PaO 2 PaCO 2 SaO 2 alanine aminotransferase ALT aspartate aminotransferase AST 24 h / ph ph 1 HCO - 3 prothrombin time 17 P < 0. 05 PT activated partial ALT thromboplastin time APTT 0. 05 < P < 0. 1 2 Glasgow coma scale GCS 21 P < 0. 05 PaO 2 / FiO 2

123 1 % % % % % % % % 239 65 27. 2 61 25. 5 29 12. 1 17 7. 1 16 10. 9 6 2. 5 2 0. 8 5 2. 1 72 14 19. 4 17 23. 6 6 8. 3 8 11. 1 6 8. 3 1 1. 4 1 1. 4 3 4. 2 % % % % % % % 239 4 1. 7 8 3. 3 2 0. 8 1 0. 4 2 0. 8 2 0. 8 5 2. 1 72 4 5. 6 3 4. 2 2 4. 2 1 1. 4 0 0 0 0 1 1. 4 % % % % % % % 239 2 0. 8 2 0. 8 4 1. 7 4 1. 7 1 0. 4 1 0. 4 0 0 72 1 1. 4 2 4. 2 1 1. 4 0 0 0 0 0 0 1 1. 4 2 x 珋 ± s /min mmol /L g /L % 239 98 ± 19. 2 129. 8 ± 42. 6 80. 6 ± 21. 1 6. 3 ± 4. 5 23. 3 ± 5. 5 28. 1 ± 7. 4 45. 8 ± 20. 8 72 123 ± 21. 5 142. 1 ± 31. 2 69. 6 ± 19. 8 8. 4 ± 6. 3 18. 9 ± 5. 7 21. 1 ± 6. 9 73. 5 ± 23. 3 t 2. 26 1. 90 2. 14-2. 21 2. 15 2. 04-9. 60 P 0. 025 0. 048 0. 033 0. 027 0. 032 0. 042 0. 000 SaO 2 % ph HCO - 3 APTT s g /L 10 9 /L 10 9 /L 94. 5 ± 7. 1 7. 4 ± 0. 1 23. 5 ± 5. 8 35. 9 ± 25. 4 2. 9 ± 1. 4 14. 5 ± 6. 8 142. 1 ± 92. 9 85. 1 ± 21. 2 7. 2 ± 0. 2 17. 1 ± 7. 7 55. 3 ± 32. 6 1. 2 ± 1. 6 19. 7 ± 10. 2 95. 7 ± 68. 9 t 4. 01 6. 48 5. 20-5. 25 2. 80-3. 05 3. 90 P 0. 000 0. 000 0. 000 0. 000 0. 005 0. 002 0. 000 GCS mmol /L mmol /L ALT U /L PaO 2 135. 4 ± 10. 7 3. 3 ± 0. 6 12. 8 ± 3. 0 221. 9 ± 65. 4 95. 1 ± 43. 2 160. 4 ± 32. 1 38. 7 ± 7. 4 148. 9 ± 11. 8 3. 9 ± 0. 8 3. 8 ± 1. 9 408. 3 ± 106. 1 105. 3 ± 40. 1 152. 3 ± 41. 3 58. 4 ± 11. 8 t - 2. 38-3. 03 23. 43-1. 80 1. 78 1. 75-1. 69 P 0. 018 0. 003 0. 000 0. 072 0. 075 0. 082 0. 092 PT /min g /L 10 12 /L % s 29. 2 ± 5. 6 39. 5 ± 1. 5 21. 7 ± 3. 2 87. 0 ± 1. 7 3. 3 ± 1. 0 84. 3 ± 7. 8 14. 85 ± 0. 679 29. 5 ± 5. 9 38. 1 ± 1. 4 21. 3 ± 2. 3 87. 6 ± 3. 4 3. 2 ± 1. 1 83. 9 ± 11. 1 27. 21 ± 3. 16 t 0. 334 0. 543 0. 543-0. 163 1. 286 0. 372 1. 83 P 0. 739 0. 587 0. 263 0. 87 0. 20 0. 710 0. 064 AST U /L mmol /L 24 h ml PaCO 2 9. 1 ± 7. 1 171. 8 ± 30. 9 8. 9 ± 0. 5 2092. 1 ± 97. 7 34. 0 ± 9. 2 424. 7 ± 12. 0 12. 2 ± 1. 0 213. 2 ± 48. 2 8. 4 ± 1. 1 1878. 9 ± 166. 0 33. 4 ± 11. 6 427. 8 ± 20. 3 t 1. 44-0. 665 1. 56 1. 067 0. 447-0. 125 P 0. 150 0. 506 0. 121 0. 287 0. 655 0. 901 1 mmhg = 0. 133 kpa APTT GCS ALT PT AST

124 SaO 2 PaO 2 /FiO 2 APACHE Ⅱ 1 ph ph logistic α in = 0. 10 α out = HCO - 3 ph 3 0. 11 β = 0. 245 = - 7. 275 P = APTT 0. 000 OR = 1. 278 OR 95% CI 1. 206 ~ 1. 355 18 log ey / 1 - Y = - 7. 275 + 0. 245 2 a = 0. 05 PaO 2 /FiO 2 ph 2 = AST 10. 62 P = 0. 224 18 8 311 ph APACHEⅡ 1 APACHE Ⅱ 18 PaO 2 /FiO 2 PaO 2 /FiO 2 ph APACHEⅡ ALT 13. 68 μmol /L 8. 55 μmol /L 9 APACHEⅡ 33. 11 ~ 39. 36 6 APACHEⅡ 3 0. 11 ~ 0. 16 APACHE Ⅲ 7 ~ 8 30 ALT 3 5 ~12 10 9 /L 15 10 9 /L APACHE Ⅲ 2 27 g /L ~ 33 g /L 25% ALT HELLP AST 50% 4. 5 g /L 3 g /L 10 ALT APACHEⅡ 1. APACHE 3-4 18 3 GCS 4 12-14 2. Logistic 1

125 3 0 1 2 3 4 1 36. 0 ~ 38. 5 34. 0 ~ 36 38. 5 ~ 39 32. 0 ~ 34 30. 0 ~ 32 39. 0 ~ 41 < 30 41. 0 2 70 ~ 110 50 ~ 70 110 ~ 130 130 ~ 160 < 50 160 3 /min 12 ~ 25 10 ~ 12 25 ~ 35 6 ~ 10 35 ~ 50 < 6 50 4 /min 70 ~ 110 110 ~ 140 55 ~ 65 140 ~ 180 40 ~ 55 180 < 40 5 ph 7. 33 ~ 7. 50 7. 50 ~ 7. 60 7. 2 ~ 7. 33 7. 15 ~ 7. 25 7. 60 ~ 7. 70 < 7. 15 7. 70 6 Na + mmol /L 130 ~ 150 150 ~ 155 155 ~ 160 120 ~ 130 160 ~ 180 110 ~ 120 180 < 110 7 K + mmol /L 3. 5 ~ 5. 5 3. 0 ~ 3. 5 5. 5 ~ 6. 0 2. 5 ~ 3 6. 0 ~ 7. 0 7. 0 < 110 8 35. 36 ~ 82. 51 < 35. 36 82. 51 ~ 111. 97 111. 98 ~ 200. 37 200. 37 9 26. 5 ~ 40 40 ~ 44 44 ~ 51. 0 17. 6 ~ 26. 5 51 < 17. 6 10 9 /L 3 ~ 20 20 ~ 40 1 ~ 3 40 < 1 11 10 9 /L 100 50 ~ 100 20 ~ 50 < 20 12 g /L 25 19 ~ 25 15 ~ 19 < 15 13 mmol /L 3. 4 ~ 11. 1 11. 1 ~ 19. 3 19. 3 2. 2 ~ 3. 4 < 2. 2 14 < 35 35 ~ 52 52 ~ 86 86 ~ 135 135 15 g /L 1. 5 ~ 6. 0 1. 0 ~ 1. 5 0. 5 ~ 1 < 0. 5 16 ALT U /L < 40 40 ~ 120 120 ~ 400 400 17 PaO 2 /FiO 2 300 225 ~ 300 175 ~ 225 100 ~ 175 < 100 18 = 15 - GCS ALT 1 mmhg = 0. 133 kpa 4 GCS 11 1. 2. 3. 4 5 6 3 4 5 2 3 4 1 2 3 1 2 1 3 ALT APACHEⅡ APACHEⅢ APACHE APACHE Ⅱ APACHE Ⅲ

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