MEWS对急诊创伤患者临床评估的研究

Clinic study of MEWS on emergency trauma patients

目的评价MEWS评分对急诊科成人创伤患者临床评估的适用性和可行性。方法对213例成人创伤患者入急诊科即刻行MEWS评分,追踪其伤情、去向和1月内预后,统计分析MEWS与患者伤情、去向、预后的相关性及临床价值。结果MEWS评分分值与急诊创伤患者伤情、收ICU住院、病死呈正相关。其相关系数r分别为0.635、0.732、0.337。MEWS评分有较准确区分急诊创伤患者是否入住ICU的能力,其AUROCC为0.932,最佳截断值为4分(入急诊科即评分);MEWS评分有中等区分急诊创伤患者可能存活和可能死亡的能力,其AUROCC为0.852,最佳截断值为6(入急诊科即评分)。结论MEWS评分能够适用于对急诊创伤患者快速临床评估,尤其是对合理分流创伤患者有较高的临床价值。

Aim To access the possibility and practicability of MEWS on trauma patients in emergency department.Methods The patients who were hospitalized to emergency department with trauma were enrolled in study in 4 months.All of the 213 patients were evaluated with MEWS instantly when they were sent to emergency department.The severity of trauma,shunt and prognosis within 1 month were followed-up and their relationship,correlation with MEWS were statistical analyzed after dividing into groups retrospectively.Resuits MEWS had positive correlation with the severity of trauma,ICU hospitalization and mortality. Its correlation coefficients were 0. 635,0. 732,and 0. 337 respectively. The MEWS with AUROCC 0. 932 and the best cutoff score 4 had accurate discrimination on ICU hospitalization of emergency adult trauma patients. The MEWS with AUROCC O. 852 and the best cutoff score 6 had moderate discrimi- nation on mortality. Conclusion MEWS can be applied to evaluate quickly the emergency trauma patients, especially in distribution.