三种创伤评分法对群体伤患者死亡危险的预测价值  

Value of hree Trauma Scaling Systems in Predicting Death for Patients in Mass Casualties

作　　者：陈小红[1] 胡海[1] 曹钰[1] 

机构地区：[1]四川大学华西医院急诊科,成都610041

出　　处：《华西医学》2013年第9期1329-1332,共4页West China Medical Journal

摘　　要：目的探讨修正创伤评分(RTS)、CRAMS评分及院前伤情评分(PHI)对于群体伤患者死亡的评估作用。方法回顾性分析2011年8月-2012年8月就诊且记录完整的45例群体伤患者的病历资料,根据病历记录计算RTS、CRAMS及PHI评分,并记录患者是否死亡。绘制受试者工作特征曲线并计算出曲线下面积;根据约登指数筛选出各个评分适宜的截断值,据此计算3种创伤评分的灵敏度、特异度、阳性似然比、阴性似然比、阳性预测值、阴性预测值并进行比较。将患者按照性别、年龄分为亚组进行对比分析。结果 RTS曲线下面积最大,且与参考线下面积对比差异有统计学意义(P=0.016),与另外两种评分比较其差异有统计学意义。结论 RTS较CRAMS及PHI评分对于群体伤患者死亡预测具有更高的价值。Objective To discuss the value of revised trauma score （RTS）, CRAMS and prehospital index （PHI） in predicting death of patients in mass casualties. Methods We retrospectively analyzed the clinical data of 45 patients injured in mass casualties and treated in West China Hospital from August 2011 to August 2012. According to medical records, we calculated RTS, CRAMS, and PHI scores, and whether the patients were dead was also recorded. The scores were analyzed by receiver operating characteristic curve and Youden index. We calculated the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, and made contrasts. Patients were divided into groups to be compared according to their gender and age. Results The area of RTS curve was the largest, compared with the area under the reference line （P=0.016）. The cutoff point was determined by Youden Index, and the cutoff point of RTS was 4, the sensitivity was 99.9%, and the specificity was 51.3%. Conclusion RTS is more effective than CRAMS and PHI in predicting death ofpatiants who were injured in mass casualties.

关 键 词：群体伤 修正创伤评分 CRAMS评分 院前伤情评分 

分 类 号：R641[医药卫生—外科学]