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以阿帕契II評分預測加護病房病人存活率:某北區區域教學醫院的經驗
Thesis

以阿帕契II評分預測加護病房病人存活率:某北區區域教學醫院的經驗

王寧道
Masters, 國立清華大學, 高階經營管理碩士在職專班
2013

Abstract

阿帕契評分系統 死亡率 存活的機率 Apache score mortality survival rate
ABSTRACT APACHE Ⅱ score has been used as a tool for evaluation of severity of illness for ICU patients for three decades. It is also used for predicting the mortality rate for ICU patients. Different scoring system were developed over the years, however APACHE Ⅱwas the most popular one been used among all. APACHE Ⅱ was developed by Knaus et al in 1985. The scoring system is primarily based on acute physiology score, age and chronic health evaluation, which can be added up and using the total score to predict mortality rate. However, whether the scoring system can be used in all levels of medical facilities in Taiwan still need to be evaluated. There may be a possibility that predicting mortality can be achieved by fewer items. We have collected 323 patients who were admitted to medical ICU from Jan, 1st.2013 to Dec, 31st. 2013 at a regional teaching hospital in northern Taiwan to evaluate their Apache score in 24 hours and their end results of this admission. The end results of this study revealed: 1.The higher Apache score is, the lower the survival rate. One point higher in Apache score decreases the survival by 0.013 with the accuracy rate of 0.839. 2. The survival rate decreases as every one point the APS increases by 0.013 with the accuracy rate of 0.842. 3. There are four single items, mean arterial pressure, respiratory rate, GCS coma scale, and arterial oxygenation are significant correlated with survival rate, the higher the score the lower the survival rate, with different marginal effects. Keyword :Apache score、mortality、survival rate

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