Abstract：
OBJECTIVE: Acute Physiology and Chronic Health Evaluation II (APACHE II) is based on the data of intensive care unit (ICU) patients and often correlates with disease severity and prognosis. However, no prognostic predictors exist based on ICU admission data for patients with brain tumors, and no studies have reported an association between APACHE II and prognosis in patients with brain tumors. The Japanese Intensive Care Patients Database (JIPAD) was established to improve the quality of care delivered in intensive care medicine in Japan. We used JIPAD to examine factors associated with in-hospital mortality based on available data of postoperative patients with brain tumors admitted to the ICU.
METHODS: Patients aged ≥16 years enrolled in JIPAD between April 2015 and March 2018 after surgical brain tumor resection or biopsy of brain tumors. We examined factors related to outcomes at discharge based on blood tests and medical procedures performed during ICU admission, tumor type, and APACHE II score.
RESULTS: Among the 1454 patients (male:female ratio: 1:1.1, mean age: 62 years) in the study, 32 (2.2 %) died during hospital stay. In multivariate analysis, male sex (odds ratio [OR] 2.70, [95 % confidence interval, CI 1.22-6.00]), malignant tumor (OR 2.51 [95 % CI 1.13-5.55]), and APACHE II score ≥15 (OR 2.51 [95 % CI 3.08-14.3]) were significantly associated with in-hospital mortality.
CONCLUSIONS: By picking up cases with a high risk of in-hospital death at an early stage, it is possible to improve methods of treatment and support for the patient\'s family.
METHODS: Patients aged ≥16 years enrolled in JIPAD between April 2015 and March 2018 after surgical brain tumor resection or biopsy of brain tumors. We examined factors related to outcomes at discharge based on blood tests and medical procedures performed during ICU admission, tumor type, and APACHE II score.
RESULTS: Among the 1454 patients (male:female ratio: 1:1.1, mean age: 62 years) in the study, 32 (2.2 %) died during hospital stay. In multivariate analysis, male sex (odds ratio [OR] 2.70, [95 % confidence interval, CI 1.22-6.00]), malignant tumor (OR 2.51 [95 % CI 1.13-5.55]), and APACHE II score ≥15 (OR 2.51 [95 % CI 3.08-14.3]) were significantly associated with in-hospital mortality.
CONCLUSIONS: By picking up cases with a high risk of in-hospital death at an early stage, it is possible to improve methods of treatment and support for the patient\'s family.
摘要：
目的：急性生理学和慢性健康评估II（APACHEII）基于重症监护病房（ICU）患者的数据，通常与疾病严重程度和预后相关。然而,根据脑肿瘤患者的ICU入院数据，不存在预后预测因子，并且没有研究报告APACHEII与脑肿瘤患者的预后之间存在关联。日本重症监护患者数据库（JIPAD）的建立是为了提高日本重症监护医学的护理质量。我们使用JIPAD根据ICU收治的脑肿瘤术后患者的可用数据来检查与院内死亡率相关的因素。
方法：2015年4月至2018年3月，在脑肿瘤手术切除或脑肿瘤活检后，年龄≥16岁的患者纳入JIPAD。我们根据血液检查和ICU入住期间的医疗程序检查了与出院时结果相关的因素，肿瘤类型,和APACHEII得分。
结果：在研究中的1454名患者中（男性：女性比例：1：1.1，平均年龄：62岁），32人（2.2%）在住院期间死亡。在多变量分析中，男性(优势比[OR]2.70，[95%置信区间，CI1.22-6.00])，恶性肿瘤（OR2.51[95%CI1.13-5.55]），APACHEII评分≥15(OR2.51[95%CI3.08-14.3])与住院死亡率显著相关.
结论：通过在早期发现院内死亡风险较高的病例，改善治疗方法和对患者家属的支持是可能的。
方法：2015年4月至2018年3月，在脑肿瘤手术切除或脑肿瘤活检后，年龄≥16岁的患者纳入JIPAD。我们根据血液检查和ICU入住期间的医疗程序检查了与出院时结果相关的因素，肿瘤类型,和APACHEII得分。
结果：在研究中的1454名患者中（男性：女性比例：1：1.1，平均年龄：62岁），32人（2.2%）在住院期间死亡。在多变量分析中，男性(优势比[OR]2.70，[95%置信区间，CI1.22-6.00])，恶性肿瘤（OR2.51[95%CI1.13-5.55]），APACHEII评分≥15(OR2.51[95%CI3.08-14.3])与住院死亡率显著相关.
结论：通过在早期发现院内死亡风险较高的病例，改善治疗方法和对患者家属的支持是可能的。
