目的 探讨改良早期预警评分系统（MEWS）在急诊抢救室的应用价值。 方法 对2012年4月－5月在急诊抢救室就诊的213例患者进行MEWS评分，分析不同分数段患者的分布特点，追踪患者入院后的去向、病情转归及收住专科病房和重症医学科（ICU/CCU）的时间。 结果 与MEWS得分≥5分的患者相比，MEWS得分＜5分者好转出院、转入专科病房的比例较高，转入ICU/CCU比例低，差异有统计学意义（P＜0.05）；不同MEWS评分段患者转入ICU/CCU的时间最短，其次是出院回家，转入专科病房的时间最长，但MEWS得分＜5分者与≥5分者出院、转入专科病房和ICU/CCU时间之间的差异无统计学意义（P＞0.05）。 结论 MEWS可以预测患者病情变化及严重程度，对医护人员及时采取救护措施、合理安排住院有一定的指导作用，值得推广应用。
目的:比较早期预警评分(EWS)和改良早期预警评分(MEWS)预测急诊住院患者死亡风险的能力。方法:随机抽取409名四川大学华西医院急诊住院患者,采用EWS和MEWS对患者进行评分,使用ROC曲线比较两者预测急诊住院患者死亡风险的能力。结果:EWS预测患者住院的曲线面积为0.849±0.132,其最佳截断值为4分;MEWS预测急诊患者住院的曲线下面积为0.876±0.124,其最佳截断值为5分。结论:MEWS较EWS对于预测急诊住院患者死亡风险有较高的效能,还可以进一步改进提高其预测能力。
ObjectivesTo compare the efficacy of acute physiology and chronic health evaluationⅡ (APACHEⅡ), national early warning score (NEWS), pulmonary embolism severity index (PESI) and Charlson comorbidity index (CCI) on pulmonary embolism (PE) prognosis.MethodsClinical data of patients with PE treated in The Second Xiangya Hospital of Central South University from 2010 to 2017 were retrospectively analyzed. They were divided into death group and survival group, and four clinical scores were calculated. The differences of risk factors between the two groups were compared. Logistic regression analysis was used to obtain the independent risk factors related to mortality. The ROC working curve was used to compare the capability of four clinical scores for PE mortality. SPSS 24.0 and Medcalc 18.2.1 software were used for statistical analysis. ResultsA total of 318 patients with PE were included, and the mortality rate was 13.2%. The APACHEⅡ, NEWS, PESI and CCI of the death group were higher than those of the survival group. There were significant differences between two groups (P<0.05). It was confirmed by logistic regression analysis that cerebrovascular disease, heart rate, leukocyte, troponin T, arterial partial pressure of oxygen, right ventricular dysfunction (RVD) were independent risk factors for 90-day mortality. The areas under the ROC curve of APACHEⅡ, CCI, PESI, NEWS were 0.886, 0.728, 0.715 and 0.731, respectively. The area under the ROC curve of APACHEⅡ was the largest, which was better than NEWS, CCI and PESI (P<0.05), and there was no significant difference among NEWS, CCI and PESI.ConclusionsAPACHEⅡ may be the best predictor of mortality in PE patients, which is superior to NEWS, CCI and PESI.