改良早期预警评分系统联合体温校正休克指数用于上消化道出血患者医院前急救病情评估的价值

The value of a modified early warning scoring system combined with body temperature adjusted shock index for pre-hospital emergency condition assessment in patients with upper gastrointestinal bleeding

目的分析改良早期预警评分系统(MEWS)联合体温校正休克指数(ASI)用于上消化道出血患者医院前急救病情评估的价值。方法选取2021年1月至2023年1月该院医院前急救的上消化道出血患者92例,根据患者不同失血量分为中重度组(失血量大于或等于500 mL,61例)和轻度组(失血量小于500 mL,31例)。比较2组患者MEWS、ASI评分,分析MEWS联合ASI用于上消化道出血患者医院前急救病情评估的价值。结果中重度组患者MEWS、ASI评分均明显高于轻度组,差异均有统计学意义(P<0.05);MEWS、ASI评分均与患者病情有关,差异均有统计学意义(优势比=2.470、2.605,P<0.05)。MEWS、ASI及联合用于上消化道出血患者医院前急救病情评估的受试者工作曲线下面积分别为0.847、0.714、0.870,均具有一定评估价值,且联合评估患者病情的价值更高。结论MEWS、ASI用于上消化道出血患者医院前急救病情评估均具有一定价值,且联合评估患者病情的价值更高。

Objective To analyze the value of the modified early warning scoring system(MEWS)combined with body temperature adjusted shock index(ASI)in the pre-hospital emergency condition assessment in patients with upper gastrointestinal bleeding.Methods A total of 92 patients with upper gastrointestinal bleeding in prehospital emergency care in this hospital from January 2021 to January 2023 were selected,and the patients were classified into a moderately severe group(blood loss≥500 mL,61 cases),and a mild group(blood loss<500 mL,31 cases)according to their different blood loss.The MEWS and ASI scores of patients in the 2 groups were compared to analyze the value of MEWS combined with ASI for pre-hospital emergency medical assessment of patients with upper gastrointestinal bleeding.Results The MEWS and ASI scores of patients in the moderately severe group were significantly higher than those of the mild group,and the differences were statistically significant(P<0.05);the MEWS and ASI scores were related to the patient′s condition,and the differences were statistically significant(OR=2.470,2.605,P<0.05).The MEWS,ASI,and the combination of subjects used for the assessment of the condition of pre-hospital emergency care for patients with upper gastrointestinal bleeding The area under the working curve was 0.847,0.714,and 0.870,respectively,all of which had some assessment value,and the combined assessment of the patient′s condition was more valuable.Conclusion Both MEWS and ASI have certain value in prehospital emergency condition assessment of patients with upper gastrointestinal bleeding,and the value of joint assessment of patients′condition is higher.