Department of Medicine, Nenagh Hospital, Nenagh, County Tipperary, Ireland.
Resuscitation. 2012 Mar;83(3):297-302. doi: 10.1016/j.resuscitation.2011.08.022. Epub 2011 Sep 10.
The early warning score derived from 198,755 vital sign sets in the Vitalpac™ database (ViEWS) has an area under the receiver operator characteristic curve (AUROC) for death of acute unselected medical patients within 24h of 88%.
This study validated an abbreviated version of ViEWS, which did not include mental status, in 75,419 consecutive patients admitted to the Thunder Bay Regional Health Sciences Center between 2005 and 2010.
The abbreviated score had an AUROC for death within 48 h of admission of 93% for all patients and 89% for medical patients - there were no significant differences in the discrimination of the score between surgical and medical patients or patients admitted to different medical sub-specialty services. The AUROC for intensive care patients, however, was significantly lower at 72%. Although medical patients appeared to have a higher mortality than surgical patients with the same score, these only reached statistical significance for surgical patients with a score between 3 and 10 points, stroke patients between 3 and 6 points, oncology patients between 7 and 10 points, and ICU patients with 3 or more points.
The abbreviated ViEWS score has comparable discrimination to the original score and has reasonable "goodness of fit" for most patients except for those requiring intensive care.
源自 Vitalpac™数据库（ViEWS）中 198755 个生命体征集的早期预警评分（ViEWS），对 24 小时内急性非选择性内科患者死亡的接受者操作特征曲线（AUROC）为 88%。
本研究验证了 ViEWS 的一个缩写版本，该版本不包括精神状态，纳入了 2005 年至 2010 年 Thunder Bay 地区健康科学中心连续收治的 75419 例患者。
对于所有患者，缩写评分的 48 小时内入院死亡 AUROC 为 93%，内科患者为 89% - 外科和内科患者或不同内科亚专科服务入院患者之间的评分区分度没有显著差异。然而，重症监护患者的 AUROC 明显较低，为 72%。尽管患有相同评分的内科患者的死亡率似乎高于外科患者，但只有外科患者评分在 3 到 10 分、中风患者评分在 3 到 6 分、肿瘤患者评分在 7 到 10 分、以及评分在 3 分及以上的重症监护患者的死亡率差异才具有统计学意义。
缩写版 ViEWS 评分与原始评分具有相当的区分度，除需要重症监护的患者外，对大多数患者具有合理的“拟合优度”。
