不同早期预警评分预测急性肺栓塞1月全因死亡率的区分度比较

Comparison of different early warning scores in predicting all-cause death of acute pulmonary embolism in one month

目的比较国家早期预警评分(NEWS)、国家早期预警评分第2版(NEWS2)、改良早期预警评分(MEWS)对急性肺栓塞患者1月全因死亡的预测价值。方法回顾性收集整理2015年1月1日—2018年12月31日在自贡市第四人民医院诊断为急性肺栓塞患者的相关数据并计算相关指标,以1月全因死亡作为终点指标,分析3种评分相互比较的曲线下面积(AUC)、净重新分类指数(NRI)、综合判别指数(IDI)。结果满足研究条件的急性肺栓塞患者261例,男性156例,年龄70[63,79]岁,1月全因死亡29(11.11%)例。NEWS的AUC值为0.692,NEWS2的AUC值为0.691,MEWS的AUC值为0.728,3种评分ROC曲线下面积比较差异无统计学意义(P>0.05)。NEWS2与MEWS比较NRI为-0.603(P=0.001)、IDI为-0.020(P=0.015)。结论NEWS2、NEWS、MEWS对预测肺栓塞1月全因死亡率有一定的价值,且MEWS预测效果高于NEWS2。

Objective Compared the predictive values of national early warning score(NEWS)、national early warning score 2(NEWS2)and modified early warning score(MEWS)on all cause death in patients with acute pulmonary embolism in one month.Methods The related data of patients with acute pulmonary embolism diagnosed in the fourth people’s Hospital of Zigong City were collected retrospectively from January 1st,2015 to December 31st,2018,and the related indexes were calculated.The area under the curve(AUC),the net reclassification improvement(NRI)and the comprehensive discriminant index integrated discrimination improvement(IDI)were analyzed.Results 261patients with acute pulmonary embolism who met the research conditions.There were 156 males,70[63,79]years old,and 29(11.11%)died.The AUC values of NEWS,NEWS2 and MEWS were 0.692,0.691 and 0.728,there was no significant difference in the area under the ROC curve among the three scores(P>0.05).NEWS2 was compared with MEWS in NRI=-0.603(P=0.001)and IDI=-0.020(P=0.015).Conclusion NEWS2、NEWS and MEWS have a certain value in predicting the all-cause mortality of pulmonary embolism in one month,and the predictive effect of MEWS is higher than NEWS2.