摘要
目的探讨校正改良早期预警评分(MEWS)结合疼痛评分在急诊内科患者预后评估的应用价值。方法选取2012年5月1日—12月1日就诊于我院急诊内科的13 125例患者,进行校正MEWS及疼痛评分,评估患者危重级别,分析病情转归。结果 13 125例患者中,门诊治疗好转离院2 405例,占18.32%;急诊留观5 675例,占43.24%,专科病房住院3 750例,占28.57%;ICU住院1 221例,占9.30%;抢救室死亡74例,占0.57%。Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级、Ⅴ级患者病死率比较,差异均有统计学意义(χ2=11 853.54,P=0.000);其中Ⅱ级、Ⅲ级、Ⅳ级、Ⅴ级较Ⅰ级降低,Ⅲ级、Ⅳ级、Ⅴ级较Ⅱ级降低,Ⅳ级、Ⅴ级较Ⅲ级降低,Ⅴ级较Ⅳ级降低,差异有统计学意义(P<0.05)。结论校正MEWS结合疼痛评分系统能更好地反应患者病情,能快速评估患者危重级别,值得在急诊内科推广应用。
Objective To evaluate the application of modified early warning score (MEWS) system with pain score system in internal emergency department. Methods A MEWS with pain score was performed in 13 125 patients admitted to the intemal emergency department of this hospital to evaluate the patients' acuity levels and analyze the outcome. Results A total of 2 405 patients were cured and left hospital ( 18.32% ), 5 675 needed emergency observation (43.24%), 3 750 transferred to wards for treatment (28.57%), 1 221 to ICU (9. 30% ), 74 died in emergency rooms (0. 57% ). There was significant differ-ence in mortality rate between patients at grades Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ (X^2 = 11 853.54, P = 0. 000) ; thereinto lower in pa-tients at grades Ⅱ, Ⅲ, Ⅳ, Ⅴ than in those at grade Ⅰ, the difference was significant ( P 〈 0. 05 ) ; lower in patients at grades Ⅲ, Ⅳ, Ⅴ than in those at grade Ⅱ (P 〈 0.05) ; lower in patients at grades Ⅳ, Ⅴ than in those at grade Ⅲ (P 〈 0. 05 ) ; lower in patients at grade V than in those at grade IV (P 〈 0. 05). Conclusion MEWS with pain score system, which can reflex patients' condition better and evaluate patients' acuity levels rapidly, is worth applying in internal emergency depart-ment.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第17期2028-2029,2032,共3页
Chinese General Practice