两种不同预警评分对救护车送入急诊科危重患者的预后评估

Prognostic Evaluation of Two Different Early Warning Scores for Critically Ill Patients Sent to the Emergency Department by Ambulance

目的探讨国家早期预警评分和沃辛生理量表对救护车送入急诊科危重患者的预后评估,为急诊临床护理工作提供评估依据。方法收集2020年1月1日-2020年12月31日某院急诊救护车送入抢救室338例危重患者,分别进行NEWS评分和WPS评分,根据预后分成死亡组55例和非死亡组283例,比较NEWS评分和WPS评分的区别;应用ROC曲线下面积比较两种评分系统对患者结局的预测。结果NEWS评分的AUC值为0.771(95%CI0.723-0.815),标准误为0.0346,WPS评分的AUC值为0.774(95%CI0.725-0.817),标准误为0.0358。WPS评分AUC值大于NEWS评分的AUC值,两个评分的AUC差为0.00270(95%CI0.024-0.029),差异无统计学意义(Z=0.200,P=0.842)。结论两种评分均具有一定的预测效能,但WPS评分更简单,更适合快速有效判断救护车危重患者入抢救室的预后评估,值得临床借鉴。

Objectives This study aims to evaluate the prognosis of critical patients sent by ambulance to the emergency department with the national early warning score and worthing physiological scale,in order to provide an evaluation basis for emergency clinical nursing.Methods Information from 338 critically ill patients admitted to the rescue room by emergency ambulance in a hospital from January 1,2020 to December 31,2020 were collected and scored with NEWS score and WPS score respectively.According to the prognosis,they were divided into the death group with 55 cases and the non-death group with 283 cases.The differences between the NEWS score and the WPS score were compared.The area under the ROC curve was used to compare the predictions of two scoring systems for patient outcomes.Results The AUC value of the NEWS score was 0.771(95%CI 0.723-0.815),and the standard error was 0.0346.The AUC value of the WPS score was 0.774(95%CI 0.725-0.817),and the standard error was 0.0358.The AUC value of the WPS score was greater than the AUC value of the NEWS score.The AUC difference between the two scores was 0.00270(95%CI 0.024-0.029),but the difference was not statistically significant(Z=0.200,P=0.842).Conclusions Both scores have a certain predictive effect,but the WPS score is simpler and more suitable for quickly and effectively judging the prognosis of critically ill patients admitted to the emergency room by ambulance,which is worthy of clinical reference.