ICU基本评分系统课件.ppt

SAPS (Simplified Acute Physiology Score) 发展历史 In 1984, Le Gall reduced former 34-variable APACHE score to 14 parameters,SAPS I In 1994,SAPS II(SAPS II score + PHM) In 2008,SAPS III SAPS II 构成：0~163 scores Physiological variable:12 variable (0~26 scores/v),include GCS Age(0\7\12\15\16\18score) Type of admission(内科0、择期6、急诊8） 3 chronic disease(AIDS\18,Hematologic malignancy\10,Meta-static cancer\9) PHM SAPS II Data Data are collected during the first 24 hours after ICU admission AgeUse the patients age in years at last birthday Heart rateUse the worst value in 24 hours, either low or high rate; if it varied from cardiac arrest (11pts) to extreme tachycardia (7pts), assign 11points. SBPUse the same method as for hearth rate : eg, if it varied from 60 mmHg to 205 mmHg, assign 13 Points. Body temperatureUse the highest temperature in °C or °F PaO2/FiO2 ratioIf ventilated or CPAP, use the lowest value of the ratio. SAPS II Data Urinary outputif the patient is in the intensive care unit for less than 24 hours, make the calculation for 24 hours. Serum urea or BUNUse the highest value in mmol// or g/L for serum urea, in mg/dL for the serum urea nitrogen. WBC countUse the worst (high or low) WBC count. Serum potassium levelUse the worst (high or low) value. Serum Sodium levelUse the worst (high or low) value. Serum bicarbonate levelUse the lowest value. BilirubinUse the highest value in micromol/L or mg/dL Glasgow coma scoreUse the lowest value. If the patient is sedated, record the estimated Glasgow coma score before sedation. SAPS II Predicted death rate Logit = -7.7631+0.0737*(SAPS II)+0.9971*ln((SAPS II)+1) Predicted Death Rate =e(Logit)/(1+e(Logit)) SAPSⅡ 24小時為緊急與否分界點；一週以上視為medical AIDS,Hematologic malignancy,Meta-static cancer 以未被sedation之前的GCS為基準 沒有呼吸器之病患則以0分記 Patients excluded :Coronary care, cardiac surgery, burn patients, age 15 years SAPS Ⅱ Very Simple and quick. (一个病人5min) Predict mortality without diagnosis. Application to individual pati