A novel scoring system for assessing the severity of electrolyte and acid-base disorders and predicting outcomes in hospitalized patients

作者：Wang, Yimei; Hu, Jiachang; Geng, Xuemei; Zhang, Xiaoyan; Xu, Xialian; Lin, Jing; Teng, Jie; Ding, Xiaoqiang^*

来源：Journal of Investigative Medicine, 2019, 67(4): 750-760.

DOI：10.1136/jim-2018-000900

• RISK SCORE
• HYPERNATREMIA
• MORTALITY
• HYPERKALEMIA
• HYPONATREMIA
• ASSOCIATION
• DISTURBANCES
• DYSNATREMIA
• PREVALENCE
• DIAGNOSIS

Electrolyte and acid-base disorders are commonly seen in critically ill and other hospitalized patients. A scoring system is needed to assess the severity of electrolyte and acid-base disorders and to predict outcome in hospital patients. Herein, we prospectively enrolled a total of 322,046 patients, including 84,700 patients in the derivation cohort and 237,346 in the validation cohort, in a large, tertiary hospital in East China from 2014 to 2017. A points-scoring system of general electrolyte and acid-base disorders with a sum of 20.8 points was generated by multiple logistic regression analysis of the derivation cohort. Receiver operating characteristic curve analysis showed that the optimal cut-off value of 2.0 was associated with 65.4% sensitivity and 88.4% specificity (area under the curve: 0.818 (95% CI 0.809 to 0.827)) to predict hospital mortality in the validation cohort. On Kaplan-Meier survival analysis, the five intervals of risk score (Q1: 0 to 2.0; Q2: 2.1 to 2.5; Q3: 2.6 to 3.3; Q4: 3.4 to 4.5; and Q5: >4.5 points) showed differences in hospital survival (p<0.001). Elevated (delta) risk score >2 during hospitalization increased the risk of hospital death, while those with a delta risk score <0 and <-2 points had higher survival rates. This novel scoring system could be used to evaluate and to dynamically monitor the severity of electrolyte and acid-base disorders in hospitalized patients.

• 出版日期2019-4
• 单位复旦大学