Weiss M, Bernoulli L, Zollinger A
Intensivstation und Neonatologie-Abteilung, Universitäts-Kinderklinik, Steinwiesstrasse 75, CH-8032 Zürich, Schweiz.
Anaesthesist. 2001 Mar;50(3):150-4. doi: 10.1007/s001010170030.
The NACA-scale is used in many Austrian, German and Swiss emergency medical systems for demographic description of emergency patients. Little attention has been payed to the evaluation of its construct and predictive validity. In 427 consecutive trauma patients rescued in primary mission the NACA-Scale and the Injury Severity Score (ISS) were determined. Outcome data were obtained from medical charts and by written or telephone requests. Data were analysed with Spearman-Rank-Correlation. NACA-Grade and ISS-values showed only a moderate correlation with a considerably large spread (Rho = 0.721). Both severity scores demonstrated a good correlation to mortality (Rho = 0.976/0.994) and to transfer to an ICU (Rho = 0.964/0.943), as well a moderate correlation to the duration of ICU-stay (Rho = 0.722/0.756) and of hospital stay (Rho = 0.558/0.694). The NACA-scale adequately describes life threat in trauma victims and correlates well with morbidity and mortality. Thus, it is a valuable tool for demographic purposes in emergency medical systems. For more precise prehospital severity rating in trauma patients, the NACA-scale should be supplemented or replaced by a physiologically based prehospital severity score.
在许多奥地利、德国和瑞士的紧急医疗系统中，NACA量表用于对急诊患者进行人口统计学描述。其结构效度和预测效度的评估却很少受到关注。在427例在主要任务中获救的连续创伤患者中，确定了NACA量表和损伤严重度评分（ISS）。通过病历以及书面或电话询问获取结果数据。采用Spearman等级相关分析数据。NACA分级和ISS值仅显示出中等程度的相关性，且离散度相当大（Rho = 0.721）。两种严重度评分与死亡率（Rho = 0.976/0.994）以及转入重症监护病房（ICU）（Rho = 0.964/0.943）均显示出良好的相关性，与ICU住院时间（Rho = 0.722/0.756）和住院时间（Rho = 0.558/0.694）也显示出中等程度的相关性。NACA量表能够充分描述创伤受害者的生命威胁，并且与发病率和死亡率具有良好的相关性。因此，它是紧急医疗系统中用于人口统计学目的的一个有价值的工具。对于创伤患者更精确的院前严重度分级，NACA量表应由基于生理学的院前严重度评分进行补充或替代。
