国家早期预警评分联合动脉血乳酸对不同类型急诊老年危重症患者死亡预测的研究  

Prognostic evaluation value of National Early Warning Scores combined with arterial lactate level in elderly patients with different critical illnesses in emergency department

作　　者：温伟[1] 杨鲁[1] 张新超[1] WEN Wei YANG Lu ZHANG Xinchao(Department of Emergency, Beijing Hospital, Beijing 100730, China)

机构地区：[1]北京医院急诊科,北京100730

出　　处：《临床急诊杂志》2017年第3期204-207,共4页Journal of Clinical Emergency

基　　金：卫生行业科研专项项目基金(No:201002011)

摘　　要：目的:评价国家早期预警评分(NEWS)联合动脉血乳酸对不同类型急诊老年危重症患者死亡预后评估的临床意义。方法:随机选取2013-09-2015-07我院急诊科抢救室的413例老年危重症患者。根据入院诊断分为心血管系统组、呼吸系统组和其他系统组,计算NEWS评分同时检测动脉血乳酸,电话随访患者30d转归并分为存活组和死亡组,采用受试者工作特征曲线(ROC)和Z检验评价NEWS评分、NEWS评分联合动脉血乳酸对各组患者死亡预后的评估价值。结果:NEWS评分对心血管系统组、呼吸系统组和其他系统组危重症患者30d死亡预测的ROC曲线下面积分别是0.781、0.724、0.706;NEWS评分联合动脉血乳酸对3组患者30d死亡预测的ROC曲线下面积分别是0.811、0.758、0.788。结论:NEWS评分联合动脉血乳酸对于不同系统老年危重症患者30d预后评估能力较单纯NEWS评分均有增强。Objective： To investigate the prognostic evaluation value of National Early Warning Scores com- bined with arterial lactate level in elderly patients with different critical illnesses in emergency department. Method： A total of 413 elderly patients with critical illness randomly selected from resuscitation room in emergency department of Beijing Hospital from September 2013 to July 2015 were enrolled in this study. Patients were divided into three groups：cardiovascular system, respiratory system and other systems according to the diagnosis, NEWS system was employed to analyze the patients＇condition. Arterial blood lactate level was detected. The researchers fol- lowed the 80-day death by telephone calls and patients were divided into survival group and death group according to the results. Receiver operating characteristic curve （ROC） and Z test were used to evaluate the prognostic value of NEWS score,NEWS score combined with arterial lactate blood level in different critical patients with death. Re- suit：The AUROC for NEWS score＇s abilities to predict 30 d death of cardiovascular system group, respiratory sys- tem group and other system group were respectively 0. 781,0. 724,0. 706;The AUROC for NEWS score combined with arterial blood lactate＇s abilities to predict 30 d death of the three groups were respectively 0. 811,0. 758, 0. 788. Conclusion：NEWS score combined with arterial blood lactate level had stronger abillity to predict 30 d death than that of NEWS score in the different system patients with critical illness in emergency department.

关 键 词：国家早期预警评分 动脉血乳酸 死亡风险 急诊危重症 老年 

分 类 号：R459.7[医药卫生—急诊医学]