SIRS评分、REMS评分和APACHEⅡ评分在急诊危重患者预后评估中的对比研究  

Comparative study on SIRS、REMS and APACHEⅡscore predicting outcomes of severe patients in emergency department

作　　者：李亮[1] 任艺[1] 邵旦兵[1] 刘红梅[1] 张炜[1] 许宝华[1] 唐文杰[1] 杨志洲[1] 陈娇[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

出　　处：《临床急诊杂志》2014年第5期248-250,共3页Journal of Clinical Emergency

基　　金：南京军区人才培养"122工程"项目基金资助(No:JQZD 200905);南京军区南京总医院青年基金资助(No:2011030)

摘　　要：目的:探讨SIRS评分、REMS评分和APACHEⅡ评分在评估急诊危重患者预后的作用效果,并进行对比研究。方法:对我院急诊科412例患者入院24h后分别进行SIRS评分、REMS评分和APACHEⅡ评分,追踪患者去向和预后,并根据其当次入院后病死率,比较三种评分与急诊危重患者预后的相关性,同时通过ROC曲线下面积大小,比较三种评分系统预测预后的准确度。结果:SIRS评分、REMS评分和APACHEⅡ评分分值越高,病死危险率越高;SIRS评分、REMS评分和APACHEⅡ评分的ROC曲线下面积分别为0.692、0.763和0.865。结论:三种评分系统均能预测患者的预后,其预测准确度为APACHEⅡ>REMS>SIRS;从成本效益方面考虑,REMS评分更适用于急诊患者的早期预后评估。Objective：To study the effect of SIRS、REMS and APACHEⅡscore in predicting prognosis of severe patients in emergency department.Method：Data of 412patients were collected after admission.SIRS score, REMS score and APACHEⅡscore were calculated after 24hours in emergency room.Then we tracked the whereabouts and prognosis of patients and analyzed the relevance of different scores in evaluating the prognosis of patients according to mortality.The dependability of them via area under the ROC curve was estimated.Result：Mortality rate increased with the increasing of scores.Area under ROC curve of SIRS、REMS and APACHEⅡ score were 0.692、0.763and 0.865.Conclusion：All these three scores were useful predictors of outcomes in severe patients.The predictive accuracy for prognosis were listed as APACHEⅡ〉REMS〉SIRS.Considering the cost-benefit,REMS score may be more suitable for evaluation of prognosis in emergency patients.

关 键 词：全身炎症反应综合征评分 快速急诊内科评分 慢性健康状况评分系统Ⅱ评分 急诊 ROC曲线 

分 类 号：R459.7[医药卫生—急诊医学]