Evaluation of Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU) 신경계 중환자에게 적용한 중환자 중증도 분류도구와 Glasgow coma scale의 임상적 유용성 평가원문보기
The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors ...
The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$, .734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$, .612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.
The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$, .734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$, .612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.
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문제 정의
The current study id a survey of the critical patients in the intensive care unit of C Hospital located in Seoul, Korea. It is a case control study to test the usefulness of the CPSCS and GCS for neurological patients in ICUs.
제안 방법
The analysis reveals that several statistically significant differences are found in the test of differences in mortality based on general and clinical characteristics in such areas as length of ICU stay, endotracheal tube insertion, central venous catheter, and severity of CPSCS. The differences in relation to the length of ICU stay is supported by Kanus, Wagner, Zimmerman, and Draper's(1993) report on the mortality of their patients.
0. The general and clinical characteristics of the patients were analyzed to produce technical statistics including the means, standard deviations, frequencies, and percentages. As far as the differences in death tares according to the general and clinical characteristics are concerned, the factors that showed normal distribution were analyzed with X2 and t-test and those without normal distribution were tested by Mann-Whitney and Kruskal-Wallis test.
The purpose of present study was to identify the goodness-of-fit of the CPSCS and GCS and the clinical usefulness of its death rate prediction. The following research question guided this study : Are ther any significant differences in the severity according to the general and clinical characteristics of critical patients based on the CPSCS and GCS?
대상 데이터
The present study was analyzed using medical records of 187 critical patients who were hospitalized in the intensive care unit of C Hospital from January 2008 to May 2009. The subject patients were all adults older than 18 years old with neurologic diseases.
The present study was analyzed using medical records of 187 critical patients who were hospitalized in the intensive care unit of C Hospital from January 2008 to May 2009. The subject patients were all adults older than 18 years old with neurologic diseases. We excluded patients who had burn, coronary artery diseases, and heart surgeries.
데이터처리
0, via contrasive analysis of AUC of ROC curves. Predictions of their death rates were identified using a logistic regression analysis.
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