Kellett John, Murray Alan
Hospitalist Service, Thunder Bay Regional Health Sciences Center, 980 Oliver Road, Thunder Bay, ON P78 7A5, Canada.
Dundalk Institute of Technology, Dundalk, Ireland.
Resuscitation. 2016 May;102:94-7. doi: 10.1016/j.resuscitation.2016.02.020. Epub 2016 Mar 3.
few studies have compared the discrimination of predictive scores of in-hospital mortality that used vital signs with those using laboratory results in different patient populations.
a hypothesis generating retrospective observational cohort study. A score that only used vital signs was compared with three other scores that used laboratory changes in 44,985 medical and 20,432 surgical patients.
the discrimination of the score based only on vital signs was highest for the prediction of in-hospital death within 24h. In contrast the, albeit lower, discrimination of scores based only on laboratory data remained constant for the prediction of death up to 30 days after hospital admission. Moreover, the discrimination of scores based only on laboratory data was higher in surgical than in medical patients.
in acutely ill medical patients a vital sign based score appears to predict mortality within 24h better than scores using laboratory data. This may be because in acutely ill patients vital sign changes indicate how well a patient is responding to a current insult. In contrast, for patients without acute illness laboratory data may be a more valuable indication of the patient's capacity to respond to insults in the future.
很少有研究比较在不同患者群体中，使用生命体征的院内死亡率预测评分与使用实验室检查结果的预测评分之间的辨别力。
一项生成假设的回顾性观察队列研究。将仅使用生命体征的评分与其他三项使用实验室检查变化的评分，在44985例内科患者和20432例外科患者中进行比较。
仅基于生命体征的评分在预测24小时内院内死亡方面的辨别力最高。相比之下，仅基于实验室数据的评分的辨别力虽然较低，但在预测入院后长达30天的死亡时保持不变。此外，仅基于实验室数据的评分在外科患者中的辨别力高于内科患者。
在急性病内科患者中，基于生命体征的评分似乎比使用实验室数据的评分能更好地预测24小时内的死亡率。这可能是因为在急性病患者中，生命体征的变化表明患者对当前损伤的反应程度。相比之下，对于非急性病患者，实验室数据可能是患者未来对损伤反应能力的更有价值的指标。
