两种评分系统在老年住院患者病情预警评估中的应用效度研究  

Research on application effect of two scoring systems in early warning evaluation of illness condition of elderly hospitalized patients

作　　者：连丽虹[1] 庄秋云[1] 陈金凤[1] 

机构地区：[1]广东省中山市人民医院综合科,中山市528400

出　　处：《护理实践与研究》2017年第3期12-14,共3页Nursing Practice and Research

基　　金：2015年中山市科技计划项目(2015B1194)

摘　　要：目的:探讨改良早期预警评分(MEWS)系统和急性生理与慢性健康(APACHEⅡ)评分对老年住院患者病情预警的应用效度。方法:以2015年3月~2016年9月在我院老年科收治的>65岁的1125例老年患者为研究对象,对所有入选的老年患者进行MEWS和APACHEⅡ评估;以APACHEⅡ评分为标准,探究MEWS评分和APACHEⅡ评分的相关性和MEWS评分对老年患者病情预警的灵敏度和特异度。结果:MEWS评分与APACHEⅡ评分呈正相关(r=0.59,P<0.05),差异具有统计学意义。MEWS评分对危重患者的识别,其灵敏度和特异度分别为83.6%和97.9%,其最佳截断值为5分。MEWS评分对潜在危重患者的识别的灵敏度和特异度分别为93.5%和81.0%,其最佳截断值为4分。结论:MEWS评分与老年住院患者病情的严重程度具有较高的灵敏度和特异度,可用于快速判断老年患者的病情及预后评估。Objective To discuss the application effect of modified early warning score （MEWS） system and acute physiology and chronic health （ APACHEⅡ） scoring on early warning of illness condition of elderly hospitalized patients. Methods：Took 1125 elderly patients over 65 years old admitted in our hospi-tal from March 2015 to September 2016 as the research object, and MEWS and APACHE II evaluations were conducted for all elderly patients selected; A-PACHE II scoring was used as the standard to explore the correlation between MEWS scoring and APACHE II scoring and sensitivity and specificity ofMEWS scoring to the early warning of illness condition of elderly patients. Results ： MEWS scoring was of positive correlation with APACHEⅡ scoring （ r =0. 59, P 〈 0.05 ）, and the difference was statistically significant. MEWS scoring had a sensitivity and specialty of 83.6% and 97.9% respectively for theidentification of critical patients, with optimal cut - off value 5 scores. MEWS scoring had a sensitivity and specialty of 93.5% and 81.0% respectively forthe identification of potentially critical patients, with optimal cut - off value of 4 scores. Conclusion：MEWS scoring had a high sensitivity and specialty forthe severity of elderly hospitalized patients, and it could be used to judge the illness condition and prognosis evaluation of eider patients rapidly.

关 键 词：改良早期预警评分 灵敏度 特异度 最佳截断值 

分 类 号：R473.5[医药卫生—护理学]