不同的患者群体是否需要不同的早期预警评分？在撒哈拉以南非洲一家资源匮乏医院收治的急性病患者中使用的九种不同早期预警评分的表现。
Do different patient populations need different early warning scores? The performance of nine different early warning scores used on acutely ill patients admitted to a low-resource hospital in sub-Saharan Africa.
作者信息
Nakitende Immaculate, Nabiryo Joan, Namujwiga Teopista, Wasingya-Kasereka Lucien, Kellett John
机构信息
Kitovu Hospital, Masaka, Uganda
Kitovu Hospital, Masaka, Uganda.
出版信息
Clin Med (Lond). 2020 Jan;20(1):67-73. doi: 10.7861/clinmed.2019-0196. Epub 2019 Nov 8.
Abstract
BACKGROUND
Early warning scores (EWS) generated in a developed healthcare setting may not perform as well in low-resource settings in sub-Saharan Africa.
METHOD
The performance of EWS used in developed world was compared with those generated in low-resource settings in sub-Saharan Africa.
RESULTS
When tested on 1,266 acutely ill patients consecutively admitted to a low-resource Ugandan hospital there was no statistical difference in the performance of any of the EWS tested. The performance of all the scores appeared to be improved by the addition of mobility assessment. Although statistically insignificant, the National Early Warning Score with extra points added for impaired mobility had the highest discrimination and sensitivity.
CONCLUSION
There were only marginal and no statistical differences in the performance of EWS generated in low- and high-resource healthcare settings in a cohort of unselected acutely ill medical patients admitted to a low-resource hospital in sub-Saharan Africa.
摘要
背景
在发达医疗环境中生成的早期预警评分（EWS）在撒哈拉以南非洲的低资源环境中可能表现不佳。
方法
将发达国家使用的EWS的性能与撒哈拉以南非洲低资源环境中生成的EWS进行比较。
结果
在一家资源匮乏的乌干达医院连续收治的1266例急性病患者身上进行测试时，所测试的任何EWS的性能均无统计学差异。通过增加活动能力评估，所有评分的性能似乎都有所提高。尽管在统计学上不显著，但为活动能力受损额外加分的国家早期预警评分具有最高的辨别力和敏感性。
结论
在撒哈拉以南非洲一家资源匮乏医院收治的一组未经挑选的急性病内科患者中，低资源和高资源医疗环境中生成的EWS的性能仅有微小差异，且无统计学差异。
相似文献
1
Do different patient populations need different early warning scores? The performance of nine different early warning scores used on acutely ill patients admitted to a low-resource hospital in sub-Saharan Africa.不同的患者群体是否需要不同的早期预警评分？在撒哈拉以南非洲一家资源匮乏医院收治的急性病患者中使用的九种不同早期预警评分的表现。
Clin Med (Lond). 2020 Jan;20(1):67-73. doi: 10.7861/clinmed.2019-0196. Epub 2019 Nov 8.
2
Validation of the VitalPAC™ Early Warning Score (ViEWS) in acutely ill medical patients attending a resource-poor hospital in sub-Saharan Africa.在资源匮乏的撒哈拉以南非洲的医院就诊的急性病患者中，VitalPAC™ 早期预警评分（ViEWS）的验证。
Resuscitation. 2013 Jun;84(6):743-6. doi: 10.1016/j.resuscitation.2013.02.007. Epub 2013 Feb 21.
3
In-hospital mortality of acutely ill medical patients admitted to a resource poor hospital in sub-Saharan Africa and to a Canadian regional hospital compared using the abbreviated VitalPAC Early Warning Score.使用简化的VitalPAC早期预警评分比较撒哈拉以南非洲一家资源匮乏医院和加拿大一家地区医院收治的急性病内科患者的院内死亡率。
Eur J Intern Med. 2014 Feb;25(2):142-6. doi: 10.1016/j.ejim.2013.09.013. Epub 2013 Oct 18.
4
The prediction of in-hospital mortality by mid-upper arm circumference: a prospective observational study of the association between mid-upper arm circumference and the outcome of acutely ill medical patients admitted to a resource-poor hospital in sub-Saharan Africa.通过上臂中部周长预测住院死亡率：一项前瞻性观察研究，探讨了中上臂周长与资源匮乏的撒哈拉以南非洲地区急性重病患者入院结局的关系。
Clin Med (Lond). 2018 Mar;18(2):123-127. doi: 10.7861/clinmedicine.18-2-123.
5
The mortality of acutely ill medical patients for up to 60days after admission to a resource poor hospital in sub-Saharan Africa compared with patients of similar illness severity admitted to a Danish Regional Teaching Hospital--an exploratory observational study.撒哈拉以南非洲地区资源匮乏医院收治的急重症内科患者与丹麦地区教学医院收治的病情严重程度相似患者相比，入院后60天内的死亡率——一项探索性观察研究。
Eur J Intern Med. 2016 Jan;27:24-30. doi: 10.1016/j.ejim.2015.11.018. Epub 2015 Dec 8.
6
7
Prognostic performance of ECG abnormalities compared to vital signs in acutely ill patients in a resource-poor hospital in Uganda.在乌干达一家资源匮乏医院中，急性病患者心电图异常与生命体征相比的预后表现。
Afr J Emerg Med. 2019 Jun;9(2):64-69. doi: 10.1016/j.afjem.2018.12.005. Epub 2019 Feb 7.
8
Feasibility of using an Early Warning Score for preterm or low birthweight infants in a low-resource setting: results of a mixed-methods study at a national referral hospital in Kenya.在资源匮乏环境中使用早期预警评分对早产儿或低出生体重儿的可行性：肯尼亚国家转诊医院的一项混合方法研究结果。
BMJ Open. 2020 Oct 28;10(10):e039061. doi: 10.1136/bmjopen-2020-039061.
9
Comparison of the Aotearoa New Zealand Early Warning Score and National Early Warning Score to predict adverse inpatient events in a vital sign dataset.奥塔哥新西兰预警评分与国家预警评分在生命体征数据集预测不良住院事件中的比较。
Anaesthesia. 2023 Jul;78(7):830-839. doi: 10.1111/anae.16007. Epub 2023 Mar 29.
10
Early warning scores generated in developed healthcare settings are not sufficient at predicting early mortality in Blantyre, Malawi: a prospective cohort study.在马拉维布兰太尔，发达医疗环境中生成的早期预警评分不足以预测早期死亡率：一项前瞻性队列研究。
PLoS One. 2013;8(3):e59830. doi: 10.1371/journal.pone.0059830. Epub 2013 Mar 29.
引用本文的文献
1
Effect of an Educational Intervention on Nurses' Knowledge Regarding Use of Modified Early Warning Score in Recognition of Critical Illness.教育干预对护士关于使用改良早期预警评分识别危重症知识的影响。
Open Access Emerg Med. 2025 Aug 21;17:215-232. doi: 10.2147/OAEM.S521517. eCollection 2025.
2
Prognostic Accuracy of Screening Tools for Clinical Deterioration in Adults With Suspected Sepsis in Northeastern Thailand: A Cohort Validation Study.泰国东北部疑似脓毒症成年患者临床恶化筛查工具的预后准确性：一项队列验证研究
Open Forum Infect Dis. 2024 May 2;11(5):ofae245. doi: 10.1093/ofid/ofae245. eCollection 2024 May.
3
Performance of the Universal Vital Assessment (UVA) mortality risk score in hospitalized adults with infection in Rwanda: A retrospective external validation study.卢旺达住院感染成年人中通用生命评估（UVA）死亡率评分的表现：一项回顾性外部验证研究。
PLoS One. 2022 Mar 23;17(3):e0265713. doi: 10.1371/journal.pone.0265713. eCollection 2022.
4
Oxygen use in low-resource settings: An intervention still triggered by intuition.资源匮乏地区的氧气使用：一种仍由直觉触发的干预措施。
Resusc Plus. 2020 Dec 7;4:100056. doi: 10.1016/j.resplu.2020.100056. eCollection 2020 Dec.
5
Two simple replacements for the Triage Early Warning Score to facilitate the South African Triage Scale in low resource settings.两种用于替代早期预警评分的简单方法，以促进南非分诊量表在资源匮乏环境中的应用。
Afr J Emerg Med. 2021 Mar;11(1):53-59. doi: 10.1016/j.afjem.2020.11.007. Epub 2021 Jan 6.
6
2020 - putting policy into practice.2020年——将政策付诸实践。
Clin Med (Lond). 2020 Jan;20(1):1. doi: 10.7861/clinmed.ed.20.1.1.
本文引用的文献
1
Respiratory rates observed over 15 and 30 s compared with rates measured over 60 s: practice-based evidence from an observational study of acutely ill adult medical patients during hospital admission.观察 15 秒和 30 秒的呼吸频率与测量 60 秒的呼吸频率比较：急性病成年住院患者入院期间观察性研究的基于实践证据。
QJM. 2019 Jul 1;112(7):513-517. doi: 10.1093/qjmed/hcz065.
2
Effect of a novel vital sign device on maternal mortality and morbidity in low-resource settings: a pragmatic, stepped-wedge, cluster-randomised controlled trial.一种新型生命体征监测设备对资源匮乏环境下产妇死亡率和发病率的影响：一项实用的、阶梯式、群组随机对照试验。
Lancet Glob Health. 2019 Mar;7(3):e347-e356. doi: 10.1016/S2214-109X(18)30526-6.
3
Evaluation of the feasibility and performance of early warning scores to identify patients at risk of adverse outcomes in a low-middle income country setting.在低收入和中等收入国家环境中评估预警评分识别不良结局风险患者的可行性和性能。
BMJ Open. 2018 Apr 27;8(4):e019387. doi: 10.1136/bmjopen-2017-019387.
4
Should impaired mobility on presentation be a vital sign?就诊时活动能力受损是否应该作为生命体征？
Acta Anaesthesiol Scand. 2018 Aug;62(7):945-952. doi: 10.1111/aas.13098. Epub 2018 Mar 6.
5
A complex intervention to improve implementation of World Health Organization guidelines for diagnosis of severe illness in low-income settings: a quasi-experimental study from Uganda.一项旨在改善世界卫生组织在低收入环境下严重疾病诊断指南实施的复杂干预措施：来自乌干达的准实验研究。
Implement Sci. 2017 Nov 6;12(1):126. doi: 10.1186/s13012-017-0654-0.
6
Derivation and validation of a universal vital assessment (UVA) score: a tool for predicting mortality in adult hospitalised patients in sub-Saharan Africa.通用生命评估（UVA）评分的推导与验证：一种预测撒哈拉以南非洲地区成年住院患者死亡率的工具。
BMJ Glob Health. 2017 Jul 28;2(2):e000344. doi: 10.1136/bmjgh-2017-000344. eCollection 2017.
7
How Well Are Pulses Measured? Practice-Based Evidence from an Observational Study of Acutely Ill Medical Patients During Hospital Admission.豆类的测量情况如何？一项基于观察性研究的急性病医疗患者入院期间的实践证据。
Am J Med. 2017 Jul;130(7):863.e13-863.e16. doi: 10.1016/j.amjmed.2017.01.033. Epub 2017 Feb 22.
8
Modified Early Warning Score (MEWS) Identifies Critical Illness among Ward Patients in a Resource Restricted Setting in Kampala, Uganda: A Prospective Observational Study.改良早期预警评分（MEWS）在乌干达坎帕拉资源受限环境下识别病房患者中的危重症：一项前瞻性观察性研究。
PLoS One. 2016 Mar 17;11(3):e0151408. doi: 10.1371/journal.pone.0151408. eCollection 2016.
9
Can binary early warning scores perform as well as standard early warning scores for discriminating a patient's risk of cardiac arrest, death or unanticipated intensive care unit admission?在区分患者心脏骤停、死亡或意外入住重症监护病房的风险方面，二元早期预警评分的表现能与标准早期预警评分一样好吗？
Resuscitation. 2015 Aug;93:46-52. doi: 10.1016/j.resuscitation.2015.05.025. Epub 2015 Jun 4.
10
Seven-day mortality can be predicted in medical patients by blood pressure, age, respiratory rate, loss of independence, and peripheral oxygen saturation (the PARIS score): a prospective cohort study with external validation.通过血压、年龄、呼吸频率、生活自理能力丧失及外周血氧饱和度（PARIS评分）可预测内科患者的7天死亡率：一项具有外部验证的前瞻性队列研究。
PLoS One. 2015 Apr 13;10(4):e0122480. doi: 10.1371/journal.pone.0122480. eCollection 2015.
Zotero 插件