不同评分系统对严重外伤患者预后的评估价值对比

目的：对比不同评分系统对严重外伤患者预后的评估价值。方法对海南医学院附属医院于2012年9月至2013年9月收治的400例严重外伤患者分别进行急性生理和慢性健康状况评分Ⅱ（APACHEⅡ评分）、改良早期预警评分（MEWS）及简单临床评分（SCS），对比三种评分系统对患者预后的评估效果。结果随着病死率的上升，三种评分亦随之逐渐升高。APACHEⅡ评分的误差值最小（0.026），MEWS评分的误差值最大（0.034）；APACHE评Ⅱ分的ROC曲线下面积最大（0.866），MEWS评分的曲线下面积最小（0.749）。结论 MEWS评分、APACHEⅡ评分及SCS评分均可以有效地对严重外伤患者的预后进行评估，但APACHEⅡ评分的评估准确度最高，MEWS评分准确度最低。而SCS评分系统操作方便、快速、准确度较好，更有利于早期对严重外伤患者预后的评估。

Comparison of appraisal value in different scoring for the prognosis of patients with severe trauma

Objective To compare the appraisal values in different scoring for the prognosis of patients with severe trauma. Methods A total of 400 cases of patients with severe trauma from September 2012 to September 2013 in the Affiliated Hospital of Hainan Medical University were graded by acute physiology and chronic health evaluation （APACHEⅡ）, modified early warning score （MEWS） and simple clinical scoring （SCS）. And then the effects of evaluation in three kinds of scoring systems for the prognosis of patients were compared. Results With the case fatality rate increasing, the scores of three kinds of scoring system were also increased as well. APACHEⅡshowed the minimal error value （0.026）, while MEWS showed the maximal error value （0.034）. The area under ROC curve of APACHEⅡ was maximal （0.866）, while the area under ROC curve of MEWS was least （0.749）. Conclusion All these three score systems can effectively predict the outcomes of patients with severe trauma, and the assessing accuracy is highest in APACHEⅡand lowest in MEWS. SCS scoring system is accurate and easy and fast to be used, which is more conducive to early prognosis for patients with severe trauma.