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吸入氧分数浓度对早期预警评分表现的影响：数据库分析。

The effect of fractional inspired oxygen concentration on early warning score performance: A database analysis.

机构信息

Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, Level 3, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, United Kingdom.

James Black Centre, King's College London, London SE5 9NU, United Kingdom.

出版信息

Resuscitation. 2019 Jun;139:192-199. doi: 10.1016/j.resuscitation.2019.04.002. Epub 2019 Apr 18.

DOI:10.1016/j.resuscitation.2019.04.002
PMID:31005587
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6547016/
Abstract

OBJECTIVES

To calculate fractional inspired oxygen concentration (FiO) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission.

METHODS

A multi-centre, retrospective, observational cohort study was carried out in five hospitals from two UK NHS Trusts. Adult admissions with at least one complete set of vital sign observations recorded electronically were eligible. The primary outcome measure was an 'adverse event' which comprised either in-hospital death or unplanned ICU admission. Discrimination was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC).

RESULTS

A cohort of 83,304 patients from a total of 271,363 adult admissions were prescribed oxygen. In this cohort, NEWS-FiO (AUROC 0.823, 95% CI 0.819-0.824) outperformed NEWS (AUORC 0.811, 95% CI 0.809-0.814) when predicting in-hospital death or unplanned ICU admission within 24 h of a complete set of vital sign observations.

CONCLUSIONS

NEWS-FiO generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.

摘要

目的

计算病房患者的吸入氧分数浓度（FiO）阈值，并将其添加到国家早期预警评分（NEWS）中。评估 NEWS-FiO 在预测住院死亡和计划外重症监护病房（ICU）入院方面相对于 NEWS 的性能。

方法

在来自两个英国国民保健署信托基金的五家医院进行了一项多中心、回顾性、观察性队列研究。符合条件的是至少有一组完整的生命体征观察记录的成年入院患者。主要结局指标是“不良事件”，包括住院死亡或计划外 ICU 入院。使用接收器操作特征曲线下面积（AUROC）评估鉴别能力。

结果

从总共 271363 例成年入院患者中抽取了 83304 例患者进行吸氧。在该队列中，NEWS-FiO（AUROC 0.823，95%CI 0.819-0.824）在预测完整组生命体征观察后 24 小时内的住院死亡或计划外 ICU 入院方面优于 NEWS（AUORC 0.811，95%CI 0.809-0.814）。

结论

在需要吸氧的病房患者中，NEWS-FiO 的性能优于 NEWS。这值得进一步研究，特别是在呼吸系统疾病患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d0a/6547016/944416634935/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d0a/6547016/b762ba4a8ba8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d0a/6547016/3f3932bd5e29/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d0a/6547016/944416634935/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d0a/6547016/b762ba4a8ba8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d0a/6547016/3f3932bd5e29/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d0a/6547016/944416634935/gr3.jpg

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