MEWS评分、SIRS评分和APACHEⅡ评分对急诊颅脑外伤患者预后评估的对比研究  

Comparative study of the MEWS score,SIRS score and APACHE Ⅱ score in the evaluation of the prognosis of patients with craniocerebral trauma in emergency department

作　　者：陈娇[1] 钱晓明[2] 任艺[1] 孙宝迪[1] 邵旦兵[1] 刘红梅[1] 许宝华[1] 唐文杰[1] 张炜[1] 杨志洲[1] 聂时南[1] 

机构地区：[1]南京军区南京总医院急救医学科,南京210002 [2]南京军区南京总医院干部病房二科

出　　处：《临床急诊杂志》2013年第11期528-531,共4页Journal of Clinical Emergency

基　　金：南京军区122工程重点培养对象资助项目(No:JQZD200905);南京军区青年基金课题(No:2011030)

摘　　要：目的：比较研究MEWS评分、SIRS评分和APACHEⅡ评分评估急诊颅脑外伤患者预后的性能。方法：分析206例入我科留观室及抢救室的脑外伤患者,并进行MEWS评分、SIRS评分和APACHEⅡ评分,并追踪其预后,根据其当次入院后死亡率,比较每种评分不同分值段的病死率差异,并通过ROC曲线下面积大小,比较三种评分系统对重型颅脑外伤患者预后的性能。结果：MEWS评分、SIRS评分和APACHEⅡ评分分值越高,死亡危险率越高;MEWS评分、SIRS评分和APACHEⅡ评分的ROC曲线下面积及其95%可信区间分别为0.750（0.685~0.814）、0.692（0.633~0.752）和0.865（0.814~0.915）。结论：MEWS、SIRS和APACHEⅡ这三种评分均能对颅脑外伤患者的死亡风险进行一定的评估,但是MEWS评分更能快速、较准确的对急诊颅脑外伤患者进行早期预后评估。Objective：To compare the effects of MEWS score,SIRS score and APACHEⅡscores in evaluating the prognosis of emergency patients with craniocerebral trauma.Method：228 cases of traumatic brain injuries in the observation room and intensive care units of our department were admitted in the study.Patient＇s condition were evaluated by the MEWS ratings,SIRS score and APACHEⅡscore systems and their prognosis were recorded.Relationship between mortality and different score systems were analyzed according to the size of the area under the ROC curve.Result：The higher the score,the higher the risk of death for all three score systems.The area under the ROC curve and their 95% confidence interval were 0.750（0.685~0.814）,0.692（0.633~0.752） and 0.633（0. 814~0.915） for MEWS score,SIRS score and APACHE Ⅱ score respectively.Conclusion：MEWS,SIRS and APACHE Ⅱ score systems can assess the risk of death effectively for patients with traumatic brain injury.The MEWS score may be quicker and more accurate than others.

关 键 词：改良早期预警评分 全身炎症反应综合征评分 APACHE Ⅱ评分 颅脑外伤 ROC曲线 

分 类 号：R64[医药卫生—外科学]