改良急诊早期预警评分用于急诊分诊的决策曲线分析

Improved emergency early warning scoring for decision curve analysis of emergency triage

目的探讨改良急诊早期预警评分(MEWS)用于急诊分诊的决策曲线。方法将2020年11月—2021年1月沧州市人民医院急诊科收治的198例急诊患者作为研究对象,追踪所有患者去向,根据实际转归情况将患者分为普通病房组122例(出院、门诊就诊和转入普通病房者)和监护病房组76例(收入监护病房和急诊停留期间死亡者),通过决策曲线分析MEWS用于急诊分诊患者的价值。结果两组收缩压、年龄、血氧饱和度、体温、呼吸频率、心率、AVPU、急诊室停留时间、疾病分类、呼吸支持及MEWS评分、APACHEⅡ评分对比差异具有统计学意义(P<0.05);多因素Logistic分析显示,心率、MEWS评分为急诊患者监护病房治疗需求的危险因素,血氧饱和度、未吸氧、低中流量吸氧为急诊患者监护病房治疗需求的保护因素(均P<0.05);决策曲线分析显示,MEWS评分可预测急诊分诊患者监护病房治疗需求。结论MEWS评分是急诊患者监护病房治疗需求的危险因素,含MEWS评分预测模型可提高急诊分诊的准确性。

Objective To explore the decision curve of modified emergency early warning score(MEWS)for emergency triage.Methods The 198 emergency patients admitted to the emergency department of our hospital from November 2020 to January 2021 were taken as the research objects,and the whereabouts of all patients were tracked.According to the actual outcome,the patients were divided into 122 cases in the general ward group(discharged,outpatient visits,and transferred to the general ward)and 76 cases in the intensive care ward group(dead in the intensive care ward and emergency stay).The Value of MEWS for emergency triage patients was analyzed through decision curve.Results The two groups had statistically significant differences in systolic blood pressure,age,blood oxygen saturation,body temperature,respiratory frequency,heart rate,AVPU,emergency room stay time,disease classification,respiratory support,MEWS score,and APACHEⅡscore(P<0.05).Multivariate Logistic analysis showed that heart rate and MEWS score were the risk factors for the treatment needs of the emergency care unit,and blood oxygen saturation,no oxygen,and low and medium flow oxygen were the protective factors for the treatment needs of the emergency care unit(all P<0.05).The analysis of the decision curve showed that the MEWS score could predict the treatment needs of the emergency triage patient intensive care unit.Conclusion MEWS score is a risk factor for the treatment needs of emergency patient care units,and the prediction model containing MEWS score can improve the accuracy of emergency triage.