Clinical Value Of APACHE ? Score In Evaluating Prognosis Of Patients With Acute Paraquat Poisoning

Objective: To explore the early evaluation value of Acute Physiology and Chronic Health ?(APACHE ?)score on the prognosis of patients with acute paraquat poisoning.Methods: The data of 229 patients with acute paraquat poisoning treated in Shengjing Hospital of China Medical University from January 2013 to March 2019 were retrospectively analyzed.According to the outcome of the patients,the patients were distributed into the survival and death groups.The systemic inflammatory response syndrome(SIRS)scores,Sequential organ failure assessment(SOFA),acute physiology and chronic health status ?(APACHE ?)score,acute physiological function ?(SAPS ?)score,severe poisoning score(PSS)at the time of admission,24 h and 48 h of admission were calculated.The scores of each scoring system in the survival and death groups were compared,and then,the predictive value of each scoring system was evaluated for the prognosis of acute paraquat poisoning according to the receiver operating characteristic cu rve(ROC)and the area under the ROC curve(AUC).Results: The SIRS score,SAPS ? score,and PSS score at admission,and the SIRS score,SOFA score,APACHE ? score,SAPS ? score,and PSS score at both time points of admission at 24 h and 48 h were statistically different(P <0.05),but there was no statistical difference in SOFA score and APACHE ? score at admission(P >0.05).When patients with acute paraquat poisoning were admitted to hospital and at 24 hours of admission,the AUC of five SIRS scores,SOFA scores,APACHE ? scores,SAPS ? scores,and PSS scoring systems were all less than 0.8,and SOFA scores,APACHE ? scores,The AUCs of the three PSS scoring systems were greater than 0.8,and there was no statistical difference between them(P <0.05).However,the APACHE ? score has the highest AUC,reaching 0.857.When the APACHE ? score is 17.5,the diagnostic accuracy rate is 80.4%,which is significantly higher than the diagnostic accuracy rate of the SOFA score(77.6%)and the diagnostic accuracy rate of the PSS score(68.8%).Its sensitivity reaches 81% and specificity reaches 80%,which is better than other scores.Conclusion: APACHE ? score at 48 h of admission more than 17.5 indicated a poor outcome in patients with acute paraquat poisoning,with a good clinical application prospect.