Merigian K S, Hedges J R, Roberts J R, Childress R A, Niehaus M A, Franklin N
Department of Emergency Medicine, University of Cincinnati College of Medicine, OH 45267-0769.
Arch Emerg Med. 1988 Sep;5(3):139-45. doi: 10.1136/emj.5.3.139.
Application of formal mental status testing in the emergency department (ED) to assess cognitive function has been hampered by the lack of a rapidly applied instrument. An Abbreviated Mental Status Examination (AMSE) with 10 test items that can be administered within five minutes by nursing personnel is described. Evaluation of the instrument on 296 ambulatory ED patients with grossly normal neurologic function showed that 93% of patients had a total score of seven or more correct answers and 83% of patients had eight or more correct answers. Application of the AMSE to 375 acute drug overdose patients at the same hospital showed a significant correlation with Glasgow Coma Scale (GCS) score. An AMSE score of seven or less was found to be more sensitive than a GCS score of 13 or less for admission to the intensive care unit (ICU) and complications in the ICU (P less than 0.001). The AMSE score may serve as a useful tool for stratifying cognitive function in acute drug overdose patients and for identifying patients at increased risk for an adverse outcome from their overdose.
由于缺乏一种能快速应用的工具，在急诊科（ED）应用正式的精神状态测试来评估认知功能受到了阻碍。本文描述了一种简短精神状态检查（AMSE），它有10个测试项目，护理人员可在5分钟内完成。对296名神经功能大致正常的急诊科门诊患者使用该工具进行评估，结果显示93%的患者总得分有7个或更多正确答案，83%的患者有8个或更多正确答案。在同一家医院对375名急性药物过量患者应用AMSE，结果显示其与格拉斯哥昏迷量表（GCS）评分有显著相关性。研究发现，对于入住重症监护病房（ICU）及在ICU出现并发症而言，AMSE得分为7分及以下比GCS得分为13分及以下更具敏感性（P小于0.001）。AMSE评分可作为一种有用的工具，用于对急性药物过量患者的认知功能进行分层，并识别因药物过量而出现不良后果风险增加的患者。
