Objective： To compare the feasibility and applicability of predicting the prognosis of patients using the Early Warning Score（MEWS） system and the Acute Physiology and Chronic Health Evaluation（APACHE Ⅱ） system ...Objective： To compare the feasibility and applicability of predicting the prognosis of patients using the Early Warning Score（MEWS） system and the Acute Physiology and Chronic Health Evaluation（APACHE Ⅱ） system in the Emergency Department.Methods： Using a prospective study method, the APACHE Ⅱ and MEWS data for 640 patients hospitalized in the Emergency Internal Medicine Department were collected. The prognoses, two scores to predict the corresponding prediction index of sensitivity, specificity and positive predictive value for the prognosis,the negative predictive value and the ROC curve for predicting the prognosis were analyzed for all patients.Results： In the prediction of the risk of mortality, the MEWS system had a high resolution. The MEWS area under the ROC curve was 0.93. The area under the ROC curve for the APACHE score was 0.79, and the difference was statistically significant（Z =4.348, P 〈 0.01）.Conclusions： Both the MEWS and APACHE Ⅱ systems can be used to determine the severity of emergency patients and have a certain predictive value for the patient＇s mortality risk. However, the MEWS system is simple and quick to operate, making it a useful supplement for APACHE Ⅱ score.展开更多
目的探讨改良早期预警评分(modified early warning score,MEWS)在急诊呼吸系统潜在危重症患者预后中的应用价值。方法对湖北医药学院附属人民医院急诊科2014年5-10月收治的566例呼吸系统患者进行MEWS评分,追踪患者预后,分析MEWS评分与...目的探讨改良早期预警评分(modified early warning score,MEWS)在急诊呼吸系统潜在危重症患者预后中的应用价值。方法对湖北医药学院附属人民医院急诊科2014年5-10月收治的566例呼吸系统患者进行MEWS评分,追踪患者预后,分析MEWS评分与患者预后的相关性;比较存活、死亡患者的MEWS分值和MEWS评分对患者预后鉴别的ROC曲线。结果死亡组MEWS评分高于存活组,差异有统计学意义(t=-10.02,P<0.05);MEWS分值与患者预后呈正相关(r=0.63,P<0.05)。以死亡为预测指标时,MEWS评分的最佳截断点为3.5分、灵敏度66%、特异度74%、阳性预测值62%、阴性预测值93%、ROC曲线下面积AZ=0.743(95%CI:0.663 0.823)。结论 MEWS评分对急诊呼吸系统潜在危重症患者预后预测有中等的分辨能力,其评分方法简单、实用,可以在急诊呼吸系统患者中使用。展开更多
目的探讨改良早期预警评分(modified early warning score,MEWS)应用于院前急救患者,评估与其预后的相关性以及实施MEWS评分表前后满意度对比。方法选择2019年2—4月对我院558例患者进行MEWS评分,评价MEWS评分与急诊抢救率、入院率、病...目的探讨改良早期预警评分(modified early warning score,MEWS)应用于院前急救患者,评估与其预后的相关性以及实施MEWS评分表前后满意度对比。方法选择2019年2—4月对我院558例患者进行MEWS评分,评价MEWS评分与急诊抢救率、入院率、病死率等预后的相关性,同时与我院未进行MEWS评分院前急救的532例进行患者家属的就诊满意率和科室对转运质量满意率比较。结果随着MEWS评分升高,患者病情越重,死亡率越高,进行MEWS评分与未进行MEWS评分的患者家属的就诊满意率和科室对转运质量满意率差异具有统计学意义(P<0.05)。结论院前急救患者抢救率、入院率、病死率均随着MEWS分值的增加而增高,院前急救患者MEWS评分有独立预测急诊患者预后的价值,应用MEWS评分在院前急救中满意度升高。展开更多
基金supported by Pudong New Area Health System leadership program(No.PWRd2016-11)National Natural Science Foundation of China(No.81360231)
文摘Objective： To compare the feasibility and applicability of predicting the prognosis of patients using the Early Warning Score（MEWS） system and the Acute Physiology and Chronic Health Evaluation（APACHE Ⅱ） system in the Emergency Department.Methods： Using a prospective study method, the APACHE Ⅱ and MEWS data for 640 patients hospitalized in the Emergency Internal Medicine Department were collected. The prognoses, two scores to predict the corresponding prediction index of sensitivity, specificity and positive predictive value for the prognosis,the negative predictive value and the ROC curve for predicting the prognosis were analyzed for all patients.Results： In the prediction of the risk of mortality, the MEWS system had a high resolution. The MEWS area under the ROC curve was 0.93. The area under the ROC curve for the APACHE score was 0.79, and the difference was statistically significant（Z =4.348, P 〈 0.01）.Conclusions： Both the MEWS and APACHE Ⅱ systems can be used to determine the severity of emergency patients and have a certain predictive value for the patient＇s mortality risk. However, the MEWS system is simple and quick to operate, making it a useful supplement for APACHE Ⅱ score.
文摘目的探讨改良早期预警评分(modified early warning score,MEWS)应用于院前急救患者,评估与其预后的相关性以及实施MEWS评分表前后满意度对比。方法选择2019年2—4月对我院558例患者进行MEWS评分,评价MEWS评分与急诊抢救率、入院率、病死率等预后的相关性,同时与我院未进行MEWS评分院前急救的532例进行患者家属的就诊满意率和科室对转运质量满意率比较。结果随着MEWS评分升高,患者病情越重,死亡率越高,进行MEWS评分与未进行MEWS评分的患者家属的就诊满意率和科室对转运质量满意率差异具有统计学意义(P<0.05)。结论院前急救患者抢救率、入院率、病死率均随着MEWS分值的增加而增高,院前急救患者MEWS评分有独立预测急诊患者预后的价值,应用MEWS评分在院前急救中满意度升高。
