早期预警评分联合Braden评分对急诊老年危重症病人预后的评估效果

doi:10.3969/j.issn.1003-9198.2022.05.012

摘要/Abstract

摘要： 目的探究改良的早期预警评分(MEWS)联合压疮危险因素评估表(Braden 评分)对急诊老年危重症病人预后的评估效果。方法选取2018年6月至2020年6月我院收治的急诊老年危重症病人204例,根据预后分为存活组(140例)和死亡组(64例)。比较2组病人的MEWS和Braden评分,绘制ROC曲线评估二者对急诊老年危重症病人预后的评估价值。结果 2组的性别比、年龄等一般资料比较差异无统计学意义,死亡组MEWS评分高于存活组,Braden评分低于存活组,2组比较差异均有统计学意义(P＜0.05)。急诊老年危重症病人MEWS分级和Braden分级为极高危者的死亡率显著高于分级较低的病人。经ROC曲线分析显示,MEWS评分和Braden评分单独应用具有一定的预测价值,AUC(95%CI)分别为0.732(0.691～0.894)、0.713(0.624～0.855)。2项指标联合应用预测急诊老年危重症病人预后的价值[AUC(95%CI)为0.895(0.831～0.945)]比单一指标均有明显提高。结论 MEWS评分联合Braden评分对急诊老年危重症病人的预后评估具有较高的价值,可以临床推广使用。

关键词: 改良的早期预警评分, Braden评分, 急诊老年危重症病人, 预后, 评估价值

Abstract: Objective To explore the predictive value of modified early warning score(MEWS) combined with Braden score for the prognosis of emergency elderly critically ill patients. Methods A total of 204 emergency elderly critically ill patients admitted to our hospital from June 2018 to June 2020 were selected and were divided into survival group(n=140) and death group(n=64) according to the prognosis. The MEWS score and Braden score were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the MEWS score and Braden score for the prognosis of the elderly critically ill patients in emergency department. Results There were no significant differences in the gender ratio, age and other general information between the two groups. The MEWS score was significantly higher and the Braden score was significantly lower in the death group than that in the survival group (P<0.05). The mortality rate of emergency elderly critically ill patients with extremely high risk according to MEWS and Braden score was significantly higher than that of the patients with low risk. ROC curve analysis showed that MEWS and Braden score alone had a certain predictive value for the prognosis, with AUC (95%CI) of 0.732 (0.691-0.894), 0.713 (0.624-0.855) respectively. The predictive efficiency of the combination of two indicators [AUC (95%CI) : 0.895 (0.831-0.945)] for the prognosis was significantly higher than that of a single indicator. Conclusions The MEWS score combined with Braden score is of high value in assessing the prognosis of the elderly critically ill patients in emergency department, and can be used in clinic.

Key words: modified early warning score, Braden score, emergency elderly critically ill patients, prognosis, evaluation value

中图分类号:

R 592

马妍, 张玉勤, 张春琰. 早期预警评分联合Braden评分对急诊老年危重症病人预后的评估效果[J]. 实用老年医学, 2022, 36(5): 483-486.

MA Yan, ZHANG Yu-qin, ZHANG Chun-yan. Predictive value of modified early warning score combined with Braden score for the prognosis of emergency elderly critically ill patients[J]. Practical Geriatrics, 2022, 36(5): 483-486.

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