摘要
目的研究修正休克指数（MSI）及传统生命体征评估指标与急诊分诊时进入抢救室患者比例的相关性，探讨其对急诊分诊的意义和优势。方法回顾性纳入2009年1月1日-5月31日就诊于北京协和医院急诊科，经急诊分诊护士测量并记录生命体征的患者22153例次，计算相应休克指数（SI）、平均动脉压（MAP）、MSI，估计MSI参考值范围；按MSI参考值范围分组后，比较各组间进入抢救室的患者比例；按脉搏、收缩压、SI、MAP、MSI不同分组，分别计算各组患者进入抢救室所占比例，并计算阳性预测值、阴性预测值及比值比（OR）。结果MSI参考值范围约为0．34～1．70次，（min·mmHg）（1mmHg=0．133kPa）；阳性预测值：MSI（16．239％）〉MAP（6．115％）〉脉搏（5．746％）〉收缩压（5．321％）〉SI（3．689％）；阴性预测值：五者接近且均较高。OR值：MSI（6．138）〉MAP（2．498）〉脉搏（2．431）〉收缩压（2．117）〉SI（1．361）。结论脉搏、收缩压、SI、MAP、MSI值与急诊分诊时进入抢救室患者比例存在相关性，可以作为指导急诊分诊的指标，其中MSI可能更优。
Objective To research on the correlation between modified shock index （MSI）, traditional vital sign assessment indexes and the proportion of patients entering resuscitation room through emergency triage, and to discuss its significance and advantages for emergency triage. Methods A total of 22 153 emergency patients between January 1 and May 31, 2009 were retrospectively analyzed. We counted the shock index （SI）, mean arterial pressure （MAP）, MSI, and evaluated the reference range of MSI, based on which, the patients were divided into groups, and the proportion of patients entering resuscitation room in each group was compared. Based on pulse, systolic blood pressure （SBP）, SI, MAP and MSI, the patients were again grouped for comparing the proportion of patients entering resuscitation room, and the positive predictive value, negative predictive value, and odds ratio （OR） were also analyzed. Results Reference value of MSI ranged from 0.34 to 1.70 times/（min · mm Hg） （1 mm Hg=0.133 kPa）. Positive predictive values： MSI （16.239%） 〉 MAP （6.115%） 〉 pulse （5.746%） 〉 SBP （5.321%） 〉 SI （3.689%）. The negative predictive values were all at high levels and similar with each other. OR： MSI （6.138） 〉 MAP （2.498） 〉 pulse （2.431） 〉 SBP （2.117） 〉 SI （1.361）. Conclusion Pulse, SBP, SI, MAP, and MSI are correlated with the proportion of patients entering resuscitation room, and can be regarded as guide for emergency triage, among which MSI may be superior to all other indexes.
出处
《华西医学》
CAS
2015年第6期1031-1034,共4页
West China Medical Journal
关键词
生命体征
平均动脉压
修正休克指数
急诊分诊
病情判断
Vital sign
Mean arterial pressure
Modified shock index
Emergency triage
Condition ）udgment
