改良早期预警评分在老年重度衰弱病人病情预测中的价值

The value of modified early warning score in predicting condition of elderly patients with severe frailty

目的:探讨改良早期预警评分(MEWS)在老年重度衰弱病人病情严重程度评估和死亡预测中的价值。方法:收集2015年10月—2019年9月云南省第一人民医院老年医学科收治的69例重度衰弱病人的临床资料进行回顾性研究,根据预后情况分为病死组和存活组。对病人的临床资料进行MEWS评分,比较各组病人MEWS评分的差异,并采用受试者工作特征曲线(ROC曲线)评价MEWS判断老年重度衰弱病人预后的准确性。结果:病死组与存活组病人MEWS评分分别为(4.76±1.35)分、(1.81±1.33)分,差异有统计学意义(P<0.001)。MEWS评分对重度衰弱病人死亡预测的ROC曲线下面积为0.925[95%CI(0.863,0.988),P<0.001],最佳截点为3.5分时Youden指数最大为0.534,敏感度为76.5%,特异度为76.8%。结论:MEWS评分对判断老年重度衰弱病人病情危重程度及预后情况具有较高的预测价值。

Objective:To explore the value of Modified Early Warning Score(MEWS)in condition assessment and prognosis of elderly patients with severe frailty.Methods:The clinical data of 69 patients with severe frailty admitted to the Department of Geriatrics in the First People′s Hospital of Yunnan Province from October 2015 to September 2019 were retrospectively studied,and they were divided into death group and survival group according to their prognosis.MEWS score was performed on the clinical data of patients,to compare the difference of MEWS score among groups,and receiver operating characteristic curve(ROC curve)was used to evaluate the accuracy of MEWS in predicting the prognosis of elderly patients with severe frailty.Results:The MEWS scores of patients in the death group and the survival group were(4.76±1.35)and(1.81±1.33),respectively,and the difference was statistically significant(P<0.001).The area under the ROC curve of MEWS score for the prediction of death in patients with severe frailty was 0.925[95%CI(0.863,0.988)P<0.001].When the optimal cut-off point was 3.5,the Youden index was the highest(0.534),the sensitivity was 76.5%,and the specificity was 76.8%.Conclusions:The MEWS score had a high predictive value for judging the critical condition and prognosis of elderly patients with severe frailty.