急诊科改良早期预警评分与入院、入院处置、死亡率及住院时间的关联
Emergency department Modified Early Warning Score association with admission, admission disposition, mortality, and length of stay.
作者信息
Delgado-Hurtado Juan J, Berger Andrea, Bansal Amit B
机构信息
General Internal Medicine, Geisinger Medical Center, Danville, PA, USA.
Henry Hood Center for Health Research, Danville, PA, USA.
出版信息
J Community Hosp Intern Med Perspect. 2016 Apr 25;6(2):31456. doi: 10.3402/jchimp.v6.31456. eCollection 2016.
Abstract
BACKGROUND
Geisinger Health System implemented the Modified Early Warning Score (MEWS) in 2011 and is fully integrated to the Electronic Medical Record (EMR). Our objective was to assess whether the emergency department (ED) MEWS (auto-calculated by EMR) is associated with admission to the hospital, admission disposition, inpatient mortality, and length of stay (LOS) 4 years after its implementation.
METHODS
A random sample of 3,000 patients' first encounter in the ED was extracted in the study period (between January 1, 2014 and May 31, 2015). Logistic regression was done to analyze whether mean, maximum, and median ED MEWS is associated with admission disposition, mortality, and LOS.
RESULTS
Mean, maximum, and median ED MEWS is associated with admission to the hospital, admission disposition, and mortality. It correlates weakly with LOS.
CONCLUSION
MEWS can be integrated to the EMR, and the score automatically generated still helps predict catastrophic events. MEWS can be used as a triage tool when deciding whether and where patients should be admitted.
摘要
背景
盖辛格医疗系统于2011年实施了改良早期预警评分（MEWS），并已完全集成到电子病历（EMR）中。我们的目的是评估急诊室（ED）的MEWS（由EMR自动计算）在实施4年后是否与住院、住院处置、住院死亡率和住院时间（LOS）相关。
方法
在研究期间（2014年1月1日至2015年5月31日）抽取了3000例患者在急诊室首次就诊的随机样本。进行逻辑回归分析，以确定急诊室MEWS的均值、最大值和中位数是否与住院处置、死亡率和住院时间相关。
结果
急诊室MEWS的均值、最大值和中位数与住院、住院处置和死亡率相关。它与住院时间的相关性较弱。
结论
MEWS可以集成到EMR中，自动生成的评分仍然有助于预测灾难性事件。在决定患者是否以及应在何处住院时，MEWS可用作分诊工具。
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