国家早期预警评分在非外伤性急诊分诊中的应用  

Application research of National Early Warning Score in non-traumatic emergency triage

作　　者：范华[1] 张华[1] 吴红缨[1] 陈亚丽 韩春萍[1] 常鸿晶 张留伟[2] 孙力超[1] FAN Hua;ZHANG Hua;WU Hongying;CHEN Yali;HAN Chunping;CHANG Hon-gjing;ZHANG Liuwei;SUN Lichao(Emergency Department,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院急诊科,北京100029 [2]北京体育大学运动人体科学学院体质与健康教研室,北京100084

出　　处：《中国急救复苏与灾害医学杂志》2021年第5期494-497,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家自然科学基金青年科学基金项目(编号:81601725);中日友好医院院级科研基金(编号:2017-2-HL-4)。

摘　　要：目的探讨国家早期预警评分(NEWS)在非外伤性急诊分诊预检分级病情评估中的应用效果.方法采用方便抽样法,选取2018年11月和2019年11月经中日友好医院急诊分诊台进入就诊的17737例非外伤患者为研究对象.按照是否应用NEWS辅助分级分为对照组(8922例)和干预组(8815例).对照组为2018年11月1日—11月30日经急诊分诊台进入就诊的患者,未应用NEWS辅助分级.干预组为2019年11月1日—11月30日经急诊分诊台进入就诊的患者,应用NEWS辅助分级.比较两组患者的危重患者过检率、漏检率,探讨Ⅰ、Ⅱ级危重患者与NEWS评分的相关性.结果干预组过检率低于对照组(P<0.001);干预组漏检率低于对照组(P<0.001);Ⅰ级患者的ROC曲线下面积为0.974(0.963~0.984),约登指数86.2%,NEWS评分的灵敏度为90.3%,特异度为95.9%;Ⅱ级患者的ROC曲线下面积为0.823(0.803~0.844),约登指数57.8%,NEWS评分的灵敏度为63.8%,特异度为94.0%.结论在急诊分诊系统中使用NEWS评分辅助分级可提高非外伤急诊预检分级的准确率,NEWS评分对Ⅰ、Ⅱ级非外伤急危重症患者有较强的相关性,适宜临床推广.Objective To explore the application effect of national early warning score(NEWS)in non-traumatic emergency triage pre examination and grading.Methods By convenient sampling method,17737 in non-traumatic patients who entered the emergency triage table of China-Japan Friendship Hospital in November 2018 and November 2019 were selected as the study objects.The patients were divided into control group(8922 cases)and intervention group(8815 cases).The patients in the control group were admitted through the emergency triage table from November 1 to November 30,2018,without the application of NEWS auxiliary grading.The patients in the intervention group were admitted to the emergency triage table fi-om November 1 to November 30,2019,and were graded with NEWS.The over examination rate and missed examination rate of the two groups were compared,and the correlation between the level I and II critical patients and NEWS score were explored.Results The over examination rate of the intervention group was lower than that of the control group(PvO.001);the missed examination rate of the intervention group was lower than that of the control group(P<0.001);the area under the ROC curve of grade I patients was 0.974(0.963-0.984),the Jordan index was 86.2%,the sensitivity of NEWS was 90.3%,and the specificity was 95.9%;the area under the ROC curve of grade II patients was 0.823(0.803〜0.844),the Jordan index was 57.8%,and the sensitivity of NEWS was 63.8%,The specificity was 94.0%.Conclusion The findings indicate that the use of NEWS assisted grading in non-traumatic emergency triage system can improve the accuracy of emergency pre examination grading.NEWS has a strong correlation with grade I and II critical patients and is suitable for clinical promotion.

关 键 词：国家早期预警评分 急诊 预检分诊 危重患者 

分 类 号：R197[医药卫生—卫生事业管理]