格拉斯哥昏迷评分与重症卵巢癌患者院内死亡相关

Glasgow Coma Score Is Associated with In-Hospital Mortality in Patients with Severe Ovarian Cancer

摘要: 背景：目前，格拉斯哥昏迷评分(GCS)在重症卵巢癌中的应用价值尚不明确。方法：从公共重症数据库MIMIC-IV提取重症卵巢癌患者的基线资料、GCS评分和预后情况，以二元logistic回归分析GCS评分是否为院内死亡的独立危险因素。绘制受试者工作特征(ROC)曲线，计算曲线下面积(AUC)以评价GCS评分对于重症监护的卵巢癌患者院内死亡的预测价值。以ROC曲线获得GCS评分最佳截止值进行生存分析，评价GCS对于重症监护的卵巢癌患者院内生存时间的影响。结果：本研究最终纳入145例重症卵巢癌患者，其中27例死亡，118例存活，院内死亡率为18.62%。死亡组的GCS评分显著小于存活组(P < 0.001)，二元logistic回归分析提示提示GCS评分是重症卵巢癌患者院内死亡的独立危险因素。以GCS评分预测重症卵巢癌患者的院内死亡的AUC为0.794，以最佳截止值12将GCS评分分为高GCS组和低GCS组，高GCS组平均生存时间为40.830天，低GCS组中位生存时间为26.856天。高GCS组相对于低GCS组的风险比为7.0976。结论：GCS评分是重症卵巢患者院内死亡的独立危险因素，GCS评分在预测重症卵巢患者院内死亡时具有中等预测价值。高GCS评分(>12分)的重症卵巢癌患者的生存时间显著低于低GCS评分患者，其死亡风险约为低GCS评分患者的7倍。

Abstract: Background: Currently, the value of Glasgow Coma Score (GCS) in severe ovarian cancer is still unclear. Methods: Based on the public intensive care database (MIMIC-IV), the baseline data, GCS score and prognosis of patients with severe ovarian cancer were extracted, and binary logistic regression was used to analyze whether the GCS score is an independent risk factor for in-hospital mortality. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to evaluate the predictive value of the GCS score for in-hospital mortality of severe ovarian cancer patients. The ROC curve was used to obtain the optimal cut-off value of the GCS score for survival analysis to evaluate the impact of GCS on the in-hospital survival time of severe ovarian cancer patients. Results: This study finally included 145 patients with severe ovarian cancer, of which 27 died and 118 survived. The in-hospital mortality rate was 18.62%. The GCS score of the death group was significantly lower than that of the survival group (P < 0.001). The binary logistic regression analysis suggested that the GCS score is an independent risk factor for in-hospital death in patients with severe ovarian cancer. The GCS score was used to predict the hospital death of severe ovarian cancer patients with an AUC of 0.794. The GCS score was divided into a high-GCS group and a low-GCS group with the optimal cut-off value of 12. The average survival time of the high-GCS group was 40.830 days, and the median survival time of the low-GCS group was 26.856 days. The hazard ratio of the high-GCS group relative to the low-GCS group was 7.0976. Conclusion: GCS score is an independent risk factor for in-hospital death of severe ovarian patients, and GCS score has a moderate predictive value in predicting the in-hospital mortality of severe ovarian patients. The survival time of severe ovarian cancer patients with high-GCS score (>12 points) is significantly lower than that of patients with low-GCS score, and the risk of death is about 7 times that of patients with low-GCS score.