比较CRAMS评分与ISS评分用于创伤患者病情及死亡风险预测的Meta分析  

Meta-analysis comparing CRAMS and ISS scores for predicting the condition and death risk of trauma patients

作　　者：史梅 王晨[2] 王峻 SHI Mei;WANG Chen;WANG Jun(Kunming Medical University School of Nursing,Kunming 650500;Affiliated Hospital of Yunnan University,Kunming 650021,China)

机构地区：[1]昆明医科大学护理学院,650500 [2]云南大学附属医院,650021

出　　处：《中国老年保健医学》2023年第1期20-24,共5页Chinese Journal of Geriatric Care

基　　金：昆明医科大学护理学院2020级研究生创新基金项目(编号:2022HLYJS14)。

摘　　要：目的综合探讨CRAMS评分与ISS评分在创伤患者病情及死亡风险预测中的临床应用价值。方法检索PubMed、CNKI、Wanfang Database、VIP等数据库中有关于CRAMS评分和(或)ISS评分用于创伤患者病情及死亡风险预测的相关文献,采用Stata14.0软件对资料进行Meta分析,得到合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比及其95%CI,绘制综合受试者工作特征曲线(sROC),以综合探讨CRAMS评分和ISS评分对创伤患者病情及死亡风险预测的准确性。结果本研究共纳入9篇文献,Meta结果显示:CRAMS评分预测的灵敏度为0.89(95%CI 0.83~0.93),特异度为0.81(95%CI 0.72~0.88),阳性似然比为4.70(95%CI 3.2~6.9),阴性似然比为0.14(95%CI 0.09~0.20),诊断比值比为34.00(95%CI 22~52),sR0C曲线下面积为0.92。ISS评分预测的灵敏度为0.72(95%CI 0.56~0.84),特异度为0.86(95%CI 0.8~0.9),阳性似然比为5.00(95%CI 4.2~5.9),阴性似然比为0.32(95%CI 0.20~0.52),诊断比值比为16.00(95%CI 10~24),sR0C曲线下面积为0.88。结论CRAMS评分和ISS评分均可用于评估创伤患者的病情及死亡风险,但从时效性等方面考虑CRAMS评分操作简便、易于掌握,院前环境下可优先选用CRAMS评分来评估创伤患者的伤情。Objective To comprehensively explore the clinical application values of CRAMS score and ISS score in predicting the condition and death risk of trauma patients.Methods The databases including PubMed, CNKI,wanfang Database, VIP and other databases with relevant literature on the prediction of the condition and mortality risk of trauma patients assessed by the CRAMS score and/or ISS score were performed.Meta-analysis of data was carried out by Stata 14.0 software, and the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic ratio and 95% CI were calculated.Then, sROC was drawn to comprehensively explore the accuracy of CRAMS and ISS scores in predicting the condition and death risk of trauma patients. Results A total of 9 articles were included.Meta results showed that the CRAMS score predicted with a sensitivity of 0.89(95% CI 0.83~0.93),specificity of 0.81(95% CI 0.72~0.88),positive likelihood ratio of 4.70(95% CI 3.2~6.9),negative likelihood ratio of 0.14(95% CI 0.09~0.20),diagnostic odds ratio of 34.00(95% CI 22~52),and area under the sROC curve of 0.92.The ISS score predicted with a sensitivity of 0.72(95% CI 0.56~0.84),specificity of 0.86(95% CI 0.8,0.9),positive likelihood ratio of 5.00(95% CI 4.2~5.9),negative likelihood ratio of 0.32(95% CI 0.20~0.52),diagnostic odds ratio of 16.00(95% CI 10~24),and area under the sROC curve of 0.88.Conclusion Both CRAMS score and ISS score can be used to evaluate the risk of illness and death of trauma patients.However, in terms of timeliness, considering that CRAMS score is easy to operate and master, it is preferred to choose the CRAMS score to judge the injury of trauma patients in the pre-hospital environment.

关 键 词：CRAMS评分 ISS评分 创伤 META分析 

分 类 号：R641[医药卫生—外科学]