Kellett J, Murray A, Woodworth S, Huang W
Thunder Bay Regional Health Sciences Center, Thunder Bay, Ontario, Canada.
Dundalk Institute of Technology, Dundalk, Ireland.
Acute Med. 2015;14(1):3-9.
little is known about the changes and trends of individual vital signs during the course of acute illness in hospital.
the weighted points of the VitalPAC Early Warning Score (ViEWS) were assigned to each vital sign value measured on 44,531 acutely ill medical patients while they were hospitalized in the Thunder Bay Regional Health Sciences Centre, Ontario, Canada. These ViEWS weighted vital signs were averaged for every 24 hour period for five days after admission and five days before death or discharge and then combined to obtain an approximation of the trajectory of each vital sign while in hospital.
compared with the other vital signs, the ViEWS weighted points for respiratory rate increase the most in patients who died in hospital and decrease the most in survivors. Combining respiratory rate with the weighted points for any of the other vital signs reduced rather than increased their monitoring performance.
trends in respiratory rate, measured by observation at the bedside and given a ViEWS weighting is the best predictor of clinical outcome; minor changes predicted clinical outcome several days in advance.
关于住院急性病病程中个体生命体征的变化和趋势，人们了解甚少。
在加拿大安大略省桑德贝地区卫生科学中心住院的44531名急性病内科患者，其每次测量的生命体征值都被赋予了VitalPAC早期预警评分（ViEWS）的加权分。在入院后五天以及死亡或出院前五天，对这些ViEWS加权生命体征每24小时进行一次平均，然后综合起来以获取住院期间每个生命体征轨迹的近似值。
与其他生命体征相比，住院死亡患者的呼吸频率ViEWS加权分增加最多，而存活患者的该加权分下降最多。将呼吸频率与其他任何生命体征的加权分相结合，会降低而非提高其监测性能。
通过床边观察测量并赋予ViEWS加权的呼吸频率趋势是临床结局的最佳预测指标；微小变化可提前数天预测临床结局。
