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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/27905


    標題: Predicting the hyperglycemic crisis death (PHD) score: a new decision rule for emergency and critical care
    作者: Huang, Chien-Cheng
    Kuo, Shu-Chun
    Chien, Tsair-Wei
    Lin, Hung-Jung
    Guo, How-Ran
    Chen, Wei-Lung
    Chen, Jiann-Hwa
    Chang, Su-Hen
    Su, Shih-Bin
    貢獻者: 醫務管理系
    關鍵字: Diabetic-Ketoacidosis
    Methodological Standards
    Adult Patients
    Experience
    Management
    Mortality
    Severity
    Mellitus
    Model
    Coma
    日期: 2013-05
    上傳時間: 2014-05-26 10:48:27 (UTC+8)
    出版者: W B Saunders Co-Elsevier Inc
    摘要: Background: We investigated independent mortality predictors of hyperglycemic crises and developed a prediction rule for emergency and critical care physicians to classify patients into mortality risk and disposition groups.Methods: This study was done in a university-affiliated medical center. Consecutive adult patients (> 18 years old) visiting the emergency department (ED) between January 2004 and December 2010 were enrolled when they met the criteria of a hyperglycemic crisis. Data were separated into derivation and validation sets-the former were used to predict the latter. December 31, 2008, was the cutoff date. Thirty-day mortality was the primary endpoint.Results: We enrolled 295 patients who made 330 visits to the ED: derivation set = 235 visits (25 deaths: 10.6%), validation set = 95 visits (10 deaths: 10.5%). We found 6 independent mortality predictors: Absent tachycardia, Hypotension, Anemia, Severe coma, Cancer history, and Infection (AHA.SCI). After assigning weights to each predictor, we developed a Predicting Hyperglycemic crisis Death (PHD) score that stratifies patients into mortality-risk and disposition groups: low (0%) (95% CI, 0-0.02%): treatment in a general ward or the ED; intermediate (24.5%) (95% CI, 14.8-39.9%): the intensive care unit or a general ward; and high (59.5%) (95% CI, 42.2-74.8%): the intensive care unit. The area under the curve for the rule was 0.946 in the derivation set and 0.925 in the validation set.Conclusions: The PHD score is a simple and rapid rule for predicting 30-daymortality and classifying mortality risk and disposition in adult patients with hyperglycemic crises. (C) 2013 Elsevier Inc. All rights reserved.
    關聯: American Journal of Emergency Medicine, v.31 n.5, pp.830-834
    Appears in Collections:[醫務管理系(所)] 期刊論文

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