英国国家早期预警评分与急诊老年患者预后的相关性分析  

Analysis between National Early Warning Score and prognosis of elderly patients in Emergency Department

作　　者：王荣欣[1] 秦俭[1] 孙长怡[1] 刘芳艳[1] 

机构地区：[1]首都医科大学宣武医院急诊科,北京100053

出　　处：《中国医药导报》2015年第13期72-75,共4页China Medical Herald

基　　金：国家卫生计生委卫生行业科研专项项目(201002011)

摘　　要：目的 研究英国国家早期预警评分（NEWS）对我国急诊老年患者病情评估的价值及可行性.方法 2013年10月～2014年5月对于我国不同地区9所三级甲等医院急诊就诊的老年患者共计1391例采用NEWS评分,并追踪预后.病情转归包括好转离院、急诊留观、专科住院、收入ICU及死亡,比较各组评分,研究NEWS评分与患者预后的相关性.结果 死亡组NEWS评分明显高于其他各组,差异均有高度统计学意义（均P＜0.01）,分数越高死亡构成比越高.以死亡为预测目标时,NEWS评分ROC下面积为0.883,A UC（95％CI）为0.829～0.937,最佳截断点为8分,＜8分组与≥8分组比较,死亡率差异有高度统计学意义（x2=114.82,P=0.00）,有中等强度的预测价值.在存活组中,以收入ICU为预测目标值时,NEWS评分ROC下面积为0.737,AUC（95％CI）为0.669～0.806,最佳截断点为6分,＜6分组与≥6分组比较,入住ICU率差异有高度统计学意义（x2=7.32,P=0.00）,亦有中等强度的预测价值.结论 NEWS评分用于老年急诊患者可以判断疾病的严重程度,具有识别潜在危重病的作用,可以进一步推广使用.Objective To study the assessment value and effectiveness of National Early Warning Score （NEWS） for the prognosis of elderly patients in Emergency Department.Methods 1391 elderly patients of emergency department in 9 hospitals of China were collected from October 2013 to May 2014.NEWS score was calculated for them.The prognosis included improved and discharged,emergency observation,wards admission,ICU admission and death.The relationship between NEWS score and prognosis of patients was analyzed.Results The study showed that increasing NEWS score was associated with worse outcome.NEWS score in death group was higher than other groups （P ＜ 0.01）.When choosing the death as the forest index,the area of ROC was 0.883,AUC （95％CI） was 0.829-0.937,the cut-off of NEWS grade was 8 scores.There was significant difference in mortality rate between less than score 8 group and greater than or equal score 8 group （x2=114.82,P=0.00）.It showed medium intensity of foresting value.When choosing the ICU admission as the forest index,the area of ROC was 0.737,A UC （95％CI） was 0.669-0.806,the cut-off of NEWS grade was 6 scores.There was significant difference in ICU admission between less than score 6 group and greater than or equal score 6 group （x2=7.32,P=0.00）.It showed medium intensity of foresting value.Conclusion NEWS can evaluate severity of elderly emergency patients and discriminate the emergency potential severity patients,it is worth further extending.

关 键 词：急诊患者 老年 英国国家早期预警评分 预后 死亡 

分 类 号：R5[医药卫生—内科学]