生理评分系统对危重病患者病情评估的价值研究  

Value of PSS in prognostic assessment of critically ill patients

作　　者：方向群[1] 汪正光[1] 黄嵘[1] 汪健蕾[1] 郑绍鹏[1] 

机构地区：[1]皖南医学院附属黄山市人民医院重症医学科,安徽黄山245000

出　　处：《中国急救医学》2011年第1期18-20,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨生理评分系统（PSS）在危重病患者病情评估和预后判断中的价值.方法 选择我科2010-03-01～2010-07-05收治的115例危重病患者为研究对象进行前瞻性研究,以入住 ICU时为观察起点, 30 d为观察终点,分别计算每一位患者的EWS评分、MEWS评分和PSS评分.结果 115例中存活66例,死亡49例.存活组EWS评分、MEWS评分、PSS评分和住ICU时间与死亡组比较差异有统计学意义（P＜0.001,P＜0.05）.随着PSS评分的增加,死亡率也逐步增加（rp=0.964,P=0.000）.EWS评分ROC曲线下面积0.732（95%可信区间0.636～0.828,P=0.000）,评分6.5分时Youden指数最大,为0.472;MEWS评分ROC曲线下面积0.776（95%可信区间0.686～0.865,P=0.000）,评分4.5分时Youden指数最大,为0.452;PSS评分 ROC曲线下面积0.801（95%可信区间0.721～0.880,P=0.042）,明显高于EWS评分、MEWS评分（P〈0.01）,PSS评分5.5分时Youden指数最大,为0.434.结论 PSS评分对危重病患者病情评估和预后判断有较好的效果,相对简单、依从性好,优于EWS评分、MEWS评分.Objective To explore the value of physiological scoring system （PSS） in evaluating the severity and prognosis of critically ill patients. Methods 115 patients who were observed as soon as hospitalized and followed up for 30 days were included prospectively. EWS, MEWS and PSS of all patients were calculated then statistical analysis were performed. Results 66 cases of all the patients survived, the rest died. There were significant differences in EWS, MEWS, PSS and the duration of hospitalization between survival group and died group（P 〈0. 001 ,P 〈0.05）. Mortality was up as PSS increased, Spearman rp was 0.964 （ P = 0. 000）. The area under the ROC of EWS was 0.732 （ 95% CI 0. 636 ~0. 828 ,P =0.000） ,Youden index was the biggest 0. 472 when EWS was 6.5. The area under the ROC of MEWS was 0.776（95% CI 0. 686 -0,865 ,P =0.000）, Youden index was the biggest 0. 452 when MEWS was 4. 5. The area under the ROC ofPSS wasO. 801（95% CI0.721 -0.880, P= 0. 042） ,Youden index was the biggest 0. 434 when PSS was 5.5. Conclusion PSS was effective to evaluating the severity and prognosis of patients and was more simple, better than EWS, MEWS.

关 键 词：生理评分系统 危重病 价值 

分 类 号：R181.34[医药卫生—流行病学]