老年晕厥患者危险分层的比较研究  

Comparative study of risk stratification of syncope for older adults

作　　者：穆洪 刘杰昕 杨洋[3] 雷洪强 刘中扬[6] 刘立旻 杨铁城[1] MU Hong;LIU Jiexin;YANG Yang;LEI Hongqiang;LIU Zhongyang;LIU Limin;YANG Tiecheng(Department of Emer-gency,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院急诊科,北京100070 [2]首都医科大学附属北京天坛医院神经心脏病学中心,北京100070 [3]解放军总医院第三医学中心,北京100039 [4]首都医科大学附属北京天坛医院全科医疗科,北京100070 [5]道真县阳溪镇卫生院,贵州遵义563519 [6]北京蛋白质组研究中心,北京102206 [7]中国医学科学院阜外医院,北京100037

出　　处：《中国急救复苏与灾害医学杂志》2021年第12期1406-1409,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家自然科学基金项目(编号:31601064,82000323)。

摘　　要：目的对照剖析老年晕厥患者的危险分层评判规则。方法对2017年1月—2019年11月就诊于首都医科大学北京天坛医院的140例老年晕厥患者分别应用ROSE规则、SFSR规则、FAINT规则快速对照评估并随访1个月,逐一对各规则的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比进行计算,并对比分析。结果随访显示140例老年晕厥患者中的45例在1个月内发生不良事件,ROSE、SFSR、FAINT规则评判的灵敏度分别是84.4%、77.8%、91.1%;各规则评判的特异度分别是87.4%、84.2%、38.9%;阴性预测值分别是92.2%、88.9%、90.2%;阴性似然比分别是0.18、0.26、0.22。ROSE、SFSR、FAINT规则与随访发生不良事件一致性分析Kappa值分别是0.698、0.602、0.228。结论3种规则对老年晕厥患者的风险评判具有不同的实践意义,综合理解有助于实现对老年患者快速危险分层。Objective To compare the risk stratification rules for older adults with syncope in the hospital.Methods From January 2017 to November 2019,140 older patients with syncope admitted in our hospital were judged by ROSE,SFSR and FAINT rules respectively.After one-month follow-up,the sensitivity,specificity,PPV,NPV,PLR and NLR were compared among different rules.Results In this study,45 patients were reported to have occurred short-term ad⁃verse incidents during one month.In order of ROSE,SFSR and FAINT rules respectively,the sensitivities were 84.4%,77.8%and 91.1%,the specificities were 87.4%,84.2%and 38.9%,the negative predictive values were 92.2%,88.9%and 90.2%,and the negative likelihood ratios were 0.18,0.26 and 0.22.The consistency analyses for ROSE,SFSR and FAINT rules'applications with follow-up adverse events were 0.698,0.602 and 0.228 respectively.Conclusion The three rules for syncope risk stratification all showed crucial importance for screening older adults.Therefore,physicians in the emergency department should flexibly understand and judge older patients'potential risks according to the actual clinical situation.

关 键 词：晕厥 老年 ROSE规则 SFSR规则 FAINT规则 

分 类 号：R743.9[医药卫生—神经病学与精神病学]