MEWS与RTS评分法对急诊创伤临床评估的比较

Comparison of Clinic Evaluation Between MEWS and RTS on Emergency Trauma Patients

【目的】评价MEWS、RTS评分对急诊科成人创伤患者临床评估能力的优劣。【方法】对213例成人创伤患者入急诊科即刻分别行MEWS、RTS评分，追踪其去向和1个月内预后，统计分析MEWS、RTS评分与患者去向、预后的相关性及临床价值，并比较两者对分流和预后评估能力的优劣。[结果]MEWS评分与创伤患者收ICU住院、病死呈正相关，而RTS呈负相关。在对创伤患者收住ICU的预测和评估的鉴别能力上，MEWS优于RTS，差异有显著统计学意义（P〈0．01）。而在对创伤患者病死危险性的预测和评估的鉴别能力上，RTS优于MEWS，差异有统计学意义（P〈0．05）。[结论]MEWS评分能够适用于对急诊创伤患者快速分流和预后的评估，尤其是对合理分流创伤患者有较高的临床价值。

[Objective]To access the possibility and practicability of MEWS and to compare its perform- ance with RTS on trauma patients in emergency department, [Methods]The patients who were hospitalized in emergency department with trauma were enrolled in this study in 4 months. All of 213 patients were evaluated with MEWS and RTS instantly when they were sent to emergency department. The shunt and prognosis with- in 1 month were followed up, and their relationship and correlation with MEWS and RTS were statistically an- alyzed and compared after dividing into groups retrospectively. [Results] The MEWS had positive correlation with ICU hospitalization and mortality,whereas the RTS had negative correlation. The MEWS had more accu- rate discrimination than RTS on ICU hospitalization of emergency adult trauma patients. And RTS had more discrimination on mortality. [Conclusion]The MEWS can be applied to quickly evaluate the emergency trauma patients, especially in reasonable distribution of patients.