Garcea Giuseppe, Jackson Benjamin, Pattenden Clare J, Sutton Christopher D, Neal Christopher P, Dennison Ashley R, Berry David P
Department of Hepatobiliary and Pancreatic Surgery, Leicester General Hospital, Leicester, England.
J Gastrointest Surg. 2006 Jul-Aug;10(7):1008-15. doi: 10.1016/j.gassur.2006.03.008.
The Early Warning Score (EWS) is a widely used general scoring system to monitor patient progress with a varying score of 0-20 in critically unwell patients. This study evaluated the EWS system compared with other established scoring systems in patients with acute pancreatitis. EWS scores were compared with APACHE scores, Imrie scores, computed tomography grading scores, and Ranson criteria for 110 admissions with acute pancreatitis. A favorable outcome was considered to be survival without intensive therapy unit admission or surgery. Nonsurvivors, necrosectomy, and critical care admission were considered adverse outcomes. EWS was the best predictor of adverse outcome in the first 24 hours of admission (receiver operating curve, 0.768). The most accurate predictor of mortality overall was EWS on day 3 of admission (receiver operating curve, 0.920). EWS correlated with duration of intensive therapy unit stay and number of ventilated days (P < 0.05) and selected those who went on to develop pancreas-specific complications such as pseudocyst or ascites. EWS of 3 or above is an indicator of adverse outcome in patients with acute pancreatitis. EWS can accurately and reliably select both patients with severe acute pancreatitis and those at risk of local complications.
早期预警评分（EWS）是一种广泛应用的通用评分系统，用于监测病情危急患者的病情进展，分数范围为0至20分。本研究将EWS系统与其他已确立的评分系统在急性胰腺炎患者中进行了评估。对110例急性胰腺炎入院患者的EWS评分与急性生理与慢性健康状况评分系统（APACHE）、Imrie评分、计算机断层扫描分级评分以及兰森标准进行了比较。良好结局定义为无需入住重症监护病房或进行手术即可存活。非幸存者、坏死组织清除术和重症监护病房入院被视为不良结局。EWS是入院后最初24小时内不良结局的最佳预测指标（受试者工作特征曲线下面积为0.768）。入院第3天时EWS是总体死亡率最准确的预测指标（受试者工作特征曲线下面积为0.920）。EWS与重症监护病房住院时间及机械通气天数相关（P<0.05），并能筛选出那些随后发生胰腺特异性并发症（如假性囊肿或腹水）的患者。EWS为3分及以上是急性胰腺炎患者不良结局的一个指标。EWS能够准确且可靠地筛选出重症急性胰腺炎患者以及有局部并发症风险的患者。
