MEWS评分在评估院前急性脑梗死患者病情及预后的应用研究  

Clinical application of MEWS assessing the conditions and prognosis of pre-hospital acute cerebral infarction

作　　者：朱远群[1] 阮海林[1] 杨春旭[1] 黄福文[1] 王承辉[1] 

机构地区：[1]广西医科大学第四附属医院柳州市工人医院,广西柳州545005

出　　处：《山东医药》2011年第20期31-33,共3页Shandong Medical Journal

基　　金：广西科学研究与技术开发计划(桂科攻0898014);广西壮族自治区卫生厅自筹经费科研课题(Z2008360);柳州市科学研究与技术开发计划(柳科攻2008031418)

摘　　要：目的研究改良早期预警(MEWS)评分系统在院前急性脑梗死患者病情评估和死亡预测的价值及可行性。方法院前急救中明确诊断为急性脑梗死患者128例,现场采集相关数据,进行MEWS评分,以收入院后90d为观察终点,结局作为观察指标,对患者进行MEWS评分工作特征曲线(ROC曲线)下面积计算,计算患者相应的预测指标。结果死亡组MEWS评分较存活组高(P<0.05);MEWS评分ROC曲线下面积为0.780,判断院前急救急性脑梗死患者危重程度的最佳截断点为≥3分,对危重病患者死亡预测的敏感度45.45%,特异度为84.61%,准确度为81.25%,约登指数为0.301。结论 MEWS评分对院前急性脑梗死患者病情评估及死亡的预测具有中等的分辨能力,此评分方法简单、实用、可操作性强,有较强的应用价值。Objective To study the significance and feasibility of modified early warning scores（MEWS） assessing the conditions and death prediction among the pre-hospital patients with acute cerebral infarction.Methods A total of 128 patients diagnosed with acute cerebral infarction were assessed onsite by using MEWS.Observation terminal was 90 days after admission taking the results as observation index and ROC was drew and the area under the curve and the predicting index were calculated.Results Among the dead patients,MEWS were more than those of the survival group with statistic significance（P0.05）.The area under ROC was 0.780 indicating that MEWS≥3 was the board line for severe pre-hospital emergency cerebral infarction with sensitivity of 45.45%,specificity of 84.61%,accuracy of 81.25% and Youden of 0.301 predicting death.Conclusion MEWS assess acute cerebral infarction and predict death with good resolution and strong application significance,which is simple,practical and applicable for pre-hospital cerebral infarction patients.

关 键 词：改良早期预警评分 脑梗塞 院前急救 病情评估 死亡 预测 

分 类 号：R743.33[医药卫生—神经病学与精神病学]