改良早期预警评分在危重创伤患者的应用价值

Clinical value of improved early warning score in critically ill trauma patients

目的探讨危重创伤患者进行改良早期预警评分（MEWS）的临床应用价值,为提高危重创伤患者临床治疗效果提供可靠依据。方法选取我院2012年2月至2013年8月前来就诊的200例危重创伤患者,依据患者年龄将其分为≤14岁组、（15-25）岁组、（26-45）岁组、（46-60）岁组、61≥岁组五个组,应用MEWS评分标准对患者进行准确评分,以各组患者出院或死亡为观察终点,记录各组患者MESW评分情况以及不同MESW评分患者救治结果,并进行统计学分析。结果≤14岁组与≥61岁组MEWS≥9分率比较差异无统计学意义（P〉0.05）;≤14岁组与15-25岁、26-45岁、46-60岁组比较差异均有统计学意义（P〈0.05）;≥61岁组与15-25岁、26-45岁、46-60岁组比较差异均有统计学意义（P〈0.05）。NEWS评分0-4分痊愈率最高,与5-8分及≥9分组比较差异均有统计学意义（P〈0.05）。结论应用改良早期预警评分系统有利于临床医师对不同年龄段的危重创伤患者依据MEWS评分采取不同的救治措施,可以更合理利用医疗资源,改善患者预后,降低死亡率,值得临床推广应用。

Objective To investigate the clinical value of improved early warning score（MEWS） in critically ill trauma patients and provide a reliable basis for improving clinical outcomes for those patients. Methods 200 critically ill trauma patients were enrolled in this study, seen in our hospital from February 2012 to August 2013. Accord-ing to their age, those patients were divided into five age groups： 0-14, 15-25, 26-45, 46-60, 61 and above. Value the patients with MEWS scoring criteria and end the evaluation when they discharged from hospital or death. Compare the MESW record score of each group as well as different MESW rated treatment outcomes with statistics. Result There is no significant difference between age group 0-14 and age group 61 and above at MEWS ≥ 9 fraction（χ2= 0.00, P〈0.05）. Age group 0-14 is significantly different from age group 15-25, 26-45 and 46-60（the χ2is 4.37, 4.43 and 4.49respectively, P 〉0.05）. Age group 61 and above is significantly different from age group 15-25, 26-45, and 46-60（the χ2is 5.91, 6.06 and 5.96, respectively, P〈0.05）. Patients with NEWS score 0-4 had highest cure rate, which is statistically significant different from groups with NEWS score 5-8 or ≥9（the χ2is 10.91 and 37.08, respectively, P〈0.05）.Conclusion The application of improved early warning scoring system is meaningful for clinicians to chose suitable treatments for critically ill trauma patients at different age according to their MEWS scores, which would improve patient outcomes, reduce mortality, increase the using of medical resources, and deserve further clinical application.