简单临床评分在急诊抢救室中的应用价值

The application value of SCS scoring system in emergency department

目的探讨简单临床评分（simpleclinicalscore，SCS）在急诊抢救室中的临床应用价值。方法对2011年7月1日至8月31日收入南京军区南京总医院急诊抢救室的655例危重症患者，通过分析SCS评分与患者实际结局的关系，以及SCS各项指标与死亡风险的相关关系，评估在急诊抢救室使用SCS评分系统的临床价值。结果655例患者中，SCS评分越高者，死亡危险率越高，不同分值的SCS评分分组之间的死亡危险率差异有统计意义（P〈0．01），不同组别间的各项指标，除“体温、不能独自站立或需要家庭护理”之外，其余各项指标在组间差异有统计学意义（P〈0．05）。SCS评分各指标二分类logistic回归分析结果显示，年龄、糖尿病、昏迷、脉搏、收缩压、呼吸频率，这6项与患者病死率有显著相关性。结论SCS评分系统适合在急诊抢救室对危重患者做出正确的评价。在急诊抢救过程中，年龄、糖尿病、昏迷、脉搏、收缩压、呼吸频率，这6项需要重点关注，以利于改善患者预后。

Objective To investigate the clinical value of the simple clinical score （SCS） in Emergency Department. Methods A total of 655 patients with critically illness admitted from July 1,2011 through August 31, 2011 were enrolled to evaluate the clinical application of SCS in emergency rescue room by analysis of the relationship between SCS and outcome of patients, and the correlation between each factor of SCS and the risk of death. Results The higher SCS, the higher hazard ratio for death. Differences in the hazard ratio for death among groups with different scores of SCS were statistical significance （ P 〈 0. 01 ） . According to Chi-square test, there were significant differences in each factor （ except body temperature ＆ unable standing or need Home Health Aide ） among the groups of SCS （ P 〈 0. 05 ）. Binary logistic regression analysis of each factor showed that age, diabetes, coma, pulse, systolic pressure and respiratory rate had significant correlation with patient mortality. After logistic regression analysis, age, diabetes, coma, pulse, systolic pressure and respiratory rate are significantly related to the mortality of patients. Conclusions The SCS scoring system is useful to make a precise evaluation of critically ill patients in the emergency department. When emergency rescue is carried out, particular stress should be focused on age, diabetes, coma, pulse, systolic pressure and respiratory rate.