改良早期预警评分和生化参数作为急性内科入院患者预后预测指标的价值：一项前瞻性研究

The value of the Modified Early Warning Score and biochemical parameters as predictors of patient outcome in acute medical admissions a prospective study.

作者信息

Perera Yashasvi Sanja, Ranasinghe Priyanga, Adikari Adikari Mudiyanselage Madura Chinthana, Welivita Welivitage Don Thilina Sampath, Perera Wickramage Malith Eranda, Wijesundara Wijesundara Mudiyanselage Dileepa Roshan, Karunanayake Sembukutti Arachchige Ajith Panduka, Constantine Godwin Roger

机构信息

Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.

出版信息

Acute Med. 2011;10(3):126-32.

PMID:21904705

Abstract

We evaluated the effectiveness of MEWS and biochemical parameters in predicting outcomes for acute medical admissions. Data from consecutive admissions to the Acute Medical Unit (AMU) of National Hospital of Sri Lanka were collected. C-reactive protein (CRP), albumin, white cell count, platelet count and haemoglobin values were collected. Adverse endpoints were HDU/ICU admission,cardio-respiratory emergency/resuscitation and death. A MEWS score of >=5 together with increasing age,pulse rate, respiratory rate, AVPU score, CRP,CRP/Albumin ratio and reduced platelet and albumin levelall increased the odds of reaching "adverse endpoints". Adding a score for biochemical parameters increased the area under the ROC curve for reaching "adverse endpoints" Biochemical parameters better predicted length of hospital stay and adverse outcomes. A combined scoring system improved the sensitivity of prediction.

摘要

我们评估了改良早期预警评分（MEWS）和生化指标对急性内科住院患者预后的预测效果。收集了斯里兰卡国家医院急性内科病房（AMU）连续入院患者的数据。采集了C反应蛋白（CRP）、白蛋白、白细胞计数、血小板计数和血红蛋白值。不良终点包括入住重症监护病房（HDU/ICU）、心肺紧急情况/复苏和死亡。MEWS评分≥5，同时年龄增加、脉搏率、呼吸频率、AVPU评分、CRP、CRP/白蛋白比值升高以及血小板和白蛋白水平降低，均增加了达到“不良终点”的几率。加入生化指标评分增加了达到“不良终点”的受试者工作特征曲线（ROC曲线）下面积。生化指标能更好地预测住院时间和不良结局。联合评分系统提高了预测的敏感性。