中国全科医学2016，Vol.19Issue(12)：1414-1419,6.DOI:10.3969/j.issn.1007-9572.2016.12.012
改良早期预警评分和生理评分系统及危险患者评分对急诊科抢救室患者预后评估的应用价值研究
Application Value of MEWS,PSS,PARS in the Prognosis Evaluation of Patients in Rescue Room of Emergency Department
摘要
Abstract
Objective To explore the application value of modified early warning score( MEWS),physiological scoring system(PSS)and patient at risk score( PARS)in the prognosis evaluation of patients in rescue room of emergency department. Methods From June 2012 to December 2013,we enrolled 3 664 patients from the rescue room of the Department of Emergency of Jiangwan Hospital. The data of the patients were collected,including gender,age,heart rate,systolic pressure, breathing rate,body temperature( armpit temperature),oxygen saturation( SPO2 ),continuous 4 h urine volume,level of consciousness. At 0,2,4 and 24 h after admission,MEWS,PSS and PARS were evaluated,and the survival and death within two weeks after admission were taken as the end points of observation. ROC curves were made,and AUC of MEWS,PSS and PARS predicting prognosis was compared among different time points. Results At 0,2,4 and 24 h after admission,the AUC of MEWS predicting prognosis was 0. 921,0. 939,0. 938 and 0. 833 respectively,with that at 24 h significantly lower than that at 2 and 4 h(Z = 2. 047,P = 0. 041;Z = 2. 020,P = 0. 043)and no significant differences among 0,2 and 4 h(P > 0. 05). At 0,2,4 and 24 h after admission,the AUC of PSS predicting prognosis was 0. 932,0. 927,0. 913 and 0. 780 respectively, with that at 24 h significantly lower than that at 0,2 and 4 h(Z = 2. 547,P = 0. 011;Z = 2. 449,P = 0. 014;Z = 2. 193,P= 0. 028)and no significant differences among 0,2 and 4 h(P > 0. 05). At 0,2,4 and 24 h after admission,the AUC of PARS predicting prognosis was 0. 933,0. 947,0. 936 and 0. 813 respectively,with that at 24 h significantly lower than that at 0,2 and 4 h(Z = 2. 121,P = 0. 034;Z = 2. 369,P = 0. 018;Z = 2. 162,P = 0. 031)and no significant differences among 0,2 and 4 h(P > 0. 05). The three scoring were not significantly different in AUC predicting prognosis at 0,2,4 and 24 h after admission(P > 0. 05). Conclusion MEWS,PSS and PARS have similar application value in the prognosis evaluation of patients in rescue room of emergency department. MEWS is simple and practical,and requires fewer necessary expense items. Therefore,we suggest the application of MEWS which can predict patients′ prognosis well shortly after admission. If MEWS score is greater than 4. 5,it indicates the potential risk of early death,which needs attention from clinical doctors.关键词
急诊室/改良早期预警评分/生理评分系统/危险患者评分/曲线下面积Key words
Emergency room/Modified early warning score/Physiological scoring system/Patients at risk score/Area under curve分类
医药卫生引用本文复制引用
卢生芳,郭玉刚,李长风,张成人,韩芸,陈丽芳,艾自胜..改良早期预警评分和生理评分系统及危险患者评分对急诊科抢救室患者预后评估的应用价值研究[J].中国全科医学,2016,19(12):1414-1419,6.基金项目
上海市虹口区卫生局重点课题立项资助项目 （）
