摘要
目的比较改良早期预警评分(modified early warning score,MEWS)与急性生理和慢性健康评分系统(acute physiological and chronic health evaluation-Ⅱ,APACHE-Ⅱ)在评估急诊内科患者病情的效果。方法 2014年1-3月,采用方便抽样法选取乌鲁木齐市某三级甲等综合医院急诊内科患者640例为研究对象,对其进行MEWS评分以及入院24h后APACHE-Ⅱ评分,比较两种评分病情评估预测指标灵敏度、特异度、阳性预测值、阴性预测值、受试者ROC曲线。结果MEWS评分与APACHE-Ⅱ评分病情评估预测价值中等,MEWS评分ROC曲线下面积为0.648,最佳截断值是4分,灵敏度0.567,特异度0.708,阳性预测值71.68%,阴性预测值55.38%;APACHE-Ⅱ评分ROC曲线下面积为0.680,最佳截断值是14分,灵敏度61.16%,特异度66.79%,阳性预测值61.16%,阴性预测值66.79%;两种评分ROC曲线下面积比较,差异无统计学意义(P>0.05)。结论 MEWS评分可用于评估少数民族地区急诊内科患者病情,其操作简单便捷,可实现对患者病情的快速、动态监测,可与APACHE-Ⅱ评分进行联合应用。
Objective To compare the feasibility and applicability of the modified early warning score(MEWS)and acute physiology and chronic health evaluationⅡ(APACHEⅡ)score in evaluating the ability of patients in emergency internal medicine.Methods Patients from emergency internal medicine in our hospital form January to March of2014were selected.Their MEWS scores APACHE-Ⅱscores of24hours after the admission and were assessed.The sensitivity,specificity,positive predictive value,negative predictive value,receiver operating curve(ROC)of two scores were compared.Results The predictive value of MEWS score and APACHE-Ⅱscore was in a moderate level.The area under the ROC curve was0.648,the optimal cut off value was4,sensitivity was0.567,specificity was0.708%,positive predictive value was71.68%,negative predictive value was55.38%;the area under the ROC curve of APACHE-Ⅱscore was0.680,the optimal cut off value was14,sensitivity was61.16%,specificity was66.79%,positive predictive value and negative predictive value were61.16%,66.79%,two area under the curve of ROC score difference was not statistically significant(P>0.05).Conclusion The MEWS score can be used to evaluate the minority area of emergency internal medicine patients,and it’s simple and easy to operate,it can achieve fast dynamic monitoring of patient’s condition,and can be combined with APACHE-Ⅱscore for use.
作者
王艳梅
李萍
侯铭
张丽
卫婷婷
阿孜古丽.买买提
Wang Yanmei;Li Ping;Hou Min;Zhang Li;Wei Tingting;Aziguli·Maimaiti(Department of Nursing,GongLi Hospital of Shanghai Pudong New District,Shanghai 200135,China;Department of Nursing,the Xinjiang Uygur Autonomous Region People’s Hospital,Urumqi 830001,China)
出处
《解放军护理杂志》
CSCD
2017年第22期53-56,共4页
Nursing Journal of Chinese People's Liberation Army
基金
浦东新区卫生系统学科带头培养计划(PWRd2016-11)
国家自然科学基金(81360231)
