REMS评分对急诊老年严重脓毒症患者预后的评估价值

目的探讨快速急诊内科评分(rapid emergency medicine score,REMS)对急诊老年严重脓毒症患者预后的评估价值,并与APACHEⅡ评分进行比较。方法收集首都医科大学宣武医院急诊抢救室收治的老年严重脓毒症256例,入院后均进行REMS评分和APACHEⅡ评分,分别比较REMS评分≤11、12~17、≥18分值患者的病死率,比较REMS与APACHEⅡ评分的差异及相关性;比较死亡组和存活组REMS评分与APACHEⅡ评分的差异。结果随着REMS分值增加,病死率和APACHEⅡ评分升高(P0.01),REMS评分与APACHEⅡ评分呈正相关(r=0.615,P=0.014);死亡组REMS评分和APACHEⅡ评分均高于存活组(P0.05)。结论 REMS评分对评估急诊老年严重脓毒症患者的预后具有重要的价值,相对APACHEⅡ评分更为简单快捷。

Value of REMS Score in Prognosis Evaluation of Elderly Patients with Severe Sepsis in Emergency

Objective To explore the value of rapid emergency medicine score （REMS） in prognosis evaluation of elderly patients with severe sepsis and compare that with acute physiology and chronic health evaluation （APACHE Ⅱ） scores.Methods A total of 256 elderly patients with severe sepsis in emergency resuscitation room of Xuanwu hospital were enrolled in the study,and all the patients were tested by the REMS score and APACHE Ⅱ score after admission.The mortality rates of patients with REMS score ≤ 11,12-17,≥ 18 scores groups were respectively compared,and the differences and correlations between REMS score with APACHE Ⅱ score were also compared; the differences of REMS score and APACHE Ⅱ score were compared between death group and survival group.Results The mortality rates and APACHE Ⅱ scores were elevated with the increase of REMS scores （P ＜0.01）,and there was a positive correlation between REMS score and APACHE Ⅱ score （r =0.615,P =0.014） ; the scores of REMS and APACHE Ⅱ in death group were higher than those of survival group （P ＜0.05）.Conclusion The REMS score system has an important value in prognosis evaluation of elderly patients with severe sepsis in emergency,and it is comparatively simpler than the APACHE Ⅱ score system.