NEWS评分对老年急危重症患者病情评估的作用 - 欢迎访问中华老年多 .DOC

·临床研究· NEWS评分对老年急危重症患者病情评估的作用 王莉荔1，朱海燕1，陈 威1，贾立静1，王 坚2，沈 洪1，杜捷夫1* （1解放军总医院急诊科，北京 100853；2江苏丹阳市人民医院急诊科，丹阳 212300） 【摘 要】目的 应用国家早期预警评分系统（NEWS）评分方法对老年急危重症患者急诊病情进行评估，评价NEWS对老年患者病情的评估作用。方法 对我院急诊抢救室收治的361例≥60岁老年急危重患者进行NEWS评分，跟踪患者24h内病情变化、急诊转归停留期以及预后，绘制受试者工作特征（ROC）曲线，寻找最佳截点。以最佳截点为界分为低分组和高分组，比较两组间24h内病情变化、入住监护病房和急诊停留期间死亡，以及30d内死亡的发生率。结果 NEWS评分预测患者24h内病情变化、急诊转归、预后的ROC曲线下面积（AUROCC）分别为（0.776±0.043），（0.970±0.011），（0.861±0.039），最佳截点分别为7分，6分，8分。以6分为最佳截点，分为高分组与低分组，比较两组之间24h内病情变化、入住监护病房和急诊停留期间死亡，以及30d内死亡的发生率，差异有统计学意义（P＜0.01）。结论 NEWS能有效评估老年急危重症患者病情。 【关键词】病情评估；早期预警评分方法；急诊医疗服务；老年人 【中图分类号】 R459.7; R592 【文献标识码】 A 【DOI】 ? Performance of national early warning score in assessment of acute severe diseases in elderly WANG Li-Li1, ZHU Hai-Yan1, CHEN Wei1, JIA Li-Jing1, WANG Jian2, SHEN Hong1, DU Jie-Fu1* (1Department of Emergency, Chinese PLA General Hospital, Beijing 100853, China; 2Department of Emergency, Danyang People’s Hospital of Jiangsu Province, Danyang 212300, China) 【Abstract】 Objective To investigate the performance of national early warning score (NEWS) in the assessment of patient deterioration for the elderly with acute severe diseases. Methods A total of 361 elderly patients at an age of over 60 years with acute severe diseases admitted in our department from October 2013 to March 2014 were enrolled in this study. NEWS system was employed to analyze the patients’ condition. Their unanticipated circumstances within 24 h, intensive care unit admission, therapeutic outcomes and prognosis were followed up and recorded. Receiver operating characteristic (ROC) curve was drawn in different conditions in order to find the best cut-off value. Then according to the obtained best cut-off value, the cohort was divided into high-score group and low-score group. Their unanticipated circumstances within 24 h after admission, intensive care unit admission, death in department of emergency, and mortality within 30 d were compared between 2 groups. Results The area unde