改良早期预警评分在预测急诊呼吸系统潜在危重症患者预后中的应用

目的探讨改良早期预警评分(modified early warning score,MEWS)在急诊呼吸系统潜在危重症患者预后中的应用价值。方法对湖北医药学院附属人民医院急诊科2014年5-10月收治的566例呼吸系统患者进行MEWS评分,追踪患者预后,分析MEWS评分与患者预后的相关性;比较存活、死亡患者的MEWS分值和MEWS评分对患者预后鉴别的ROC曲线。结果死亡组MEWS评分高于存活组,差异有统计学意义(t=-10.02,P0.05);MEWS分值与患者预后呈正相关(r=0.63,P0.05)。以死亡为预测指标时,MEWS评分的最佳截断点为3.5分、灵敏度66%、特异度74%、阳性预测值62%、阴性预测值93%、ROC曲线下面积AZ=0.743(95%CI:0.663 0.823)。结论 MEWS评分对急诊呼吸系统潜在危重症患者预后预测有中等的分辨能力,其评分方法简单、实用,可以在急诊呼吸系统患者中使用。

Application of Modified Early Warning Score in Predicting the Prognosis of Potential Critical Respiratory System Disease

Objective To discuss application value of modified early warning score (MEWS)in potential critical respiratory system disease in the emergency department.Methods Totally 566 cases with respiratory system that hospitalized from May 2014 to October 2014 in emergency department of our hospital were selected,and the MEWS score was evaluated,the patients’prognosis was tracked.The correlationship between MEWS score and patients’prognosis was analyzed.The MEWS score and ROC curve was compared between survival and dead ca-ses.Results MEWS score of dead cases were higher than survival cases,the difference was statistically significant (t =-10.02,P <0.05),MEWS score was positively correlated with the prognosis (r =0.63,P <0.05).The death was setted as the predictive index,the best cut-off point was 3.5,sensitivity 66%,specificity 74%,positive predic-tive value 62%,negative predictive value 93%,the area under the ROC curve:AZ=0.743(95%CI :0.663 0.823). Conclusions MEWS have moderate predictive value in patient with potential critical respiratory system disease in the emergency department.MEWS is simple and practical,which is worth for clincal promotion.