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改良早期预警评分用于预测急诊潜在危重病患者预后的探讨

卫婷婷 王艳梅 侯铭 阿孜古丽·买买提 李萍   

  1. 新疆医科大学护理学院
  • 出版日期:2015-02-25 发布日期:2015-02-25
  • 基金资助:
    国家自然科学基金(81360231)

Effectiveness of Modified Early Warning Score in predicting prognosis of emergency potential critical patients

  • Online:2015-02-25 Published:2015-02-25

摘要: 目的:了解改良早期预警评分(MEWS) 对急诊潜在危重病患者预后预测的适用性和可行性。方法:对急诊2014年2-3 月接诊的670 例患者进行MEWS 评分,追踪所有患者的预后,统计分析MEWS 与患者预后的相关性;比较存活、死亡患者的MEWS 分值;MEWS 分值对患者预后预测分辨度的ROC 曲线。结果:MEWS 分值与患者预后呈正相关,相关系数为0.47,P <0.05。以死亡为预测指标时,MEWS 评分的最佳截断值为7 分,灵敏度94%,特异度94%,阳性预测值58%,阴性预测值99%,ROC 曲线下面积Az =0.947(95%CI :0.911,0.983)。结论:MEWS 对急诊患者预后具有较高程度预测价值,有一定判断潜在危重病患者的能力。MEWS 操作简单快捷,费用低廉,可实现对患者病情快速动态评估,适用于急诊患者。

Abstract: Objective: To explore the feasibility and applicability of Modified Early Warning Score (MEWS) in predicting prognosis of emergency potential critical patients. Methods: The data of 670 outpatient patients were recorded and scored with MEWS between February and March, 2014, and all patients' prognosis (survival, death) were followed up. The correlation of MEWS score and patients prognosis were statistically analyzed. The MEWS scores of survival and death patients were compared as well as area under of ROC curve of MEWS in these indexes. Results: MEWS had a positive correlation with the patient prognosis, the correlation coefficient was 0.47, and P<0.05. When the death as the predictive index, the best cut-off of MEWS grade was 7, sensitivity 94%, specificity 94%, positive predictive value 58%, negative predictive value 99%, the area under the ROC curve: Az = 0.947 (95% CI: 0.911, 0.983).Conclusion: MEWS have high predictive value of patients' prognosis, and have ability to estimate the severity of the emergency patients. MEWS is suitable for the emergency patients because its grading operation is simple and quick, low cost, and fast dynamic assessment of patient's condition.