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从重症监护病房出院时的国家早期预警评分(NEWS)的重要性。

Importance of the National Early Warning Score (NEWS) at the time of discharge from the intensive care unit.

机构信息

Department of Intensive Care, Republic of Turkey Ministry of Health Ankara City Hospital, Ankara , Turkey

Department of Anesthesiology and Reanimation, Faculty of Medicine, Hitit University, Çorum, Turkey

出版信息

Turk J Med Sci. 2020 Aug 26;50(5):1203-1209. doi: 10.3906/sag-1906-78.

Abstract

BACKROUND/AIM: To identify, at an early stage of intensive care, patients who will require readmission to the intensive care unit (ICU) based on their National Early Warning Score (NEWS-d) at discharge.

MATERIALS AND METHODS

Overall, 536 patients aged >18 years who stayed at a tertiary ICU for >24 h were included. Patients who readmitted and not readmitted to the intensive care within 48 h after discharge were compared.

RESULTS

Mean patient age was 64.26 ± 18.50 years and 252 (44.7%) patients were male. Mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 21.86 ± 8.74; mean NEWS-d was 4.48 ± 2.53. Forty-nine (9.1%) were readmitted to ICU. The reasons for initial admission, age, and NEWS-d vvalues were significantly different between the 2 groups. The NEWS-d values of the readmitted group were significantly higher (9.16 ± 1.05) than nonreadmitted group (4.01 ± 2.13). Based on receiver operation curve analysis, sensitivity and specificity were 98% and 95%, respectively, considering a NEWS-d cut-off value of 7.5 as the limit value for estimating readmission.

CONCLUSION

A NEWS-d value of >7.5 demonstrated high sensitivity and specificity in identifying the risk of readmission for patients being discharged from ICU.

摘要

背景/目的:在重症监护的早期,根据患者出院时的国家早期预警评分(NEWS-d),确定需要重新入住重症监护病房(ICU)的患者。

材料和方法

共纳入 536 名年龄>18 岁、在三级 ICU 住院>24 小时的患者。比较了出院后 48 小时内重新入住和未重新入住 ICU 的患者。

结果

患者平均年龄为 64.26 ± 18.50 岁,252 名(44.7%)患者为男性。平均急性生理学和慢性健康评估 II 评分(APACHE II)为 21.86 ± 8.74;平均 NEWS-d 为 4.48 ± 2.53。49 例(9.1%)患者重新入住 ICU。两组间初始入院原因、年龄和 NEWS-d 值差异有统计学意义。重新入住组的 NEWS-d 值明显高于未重新入住组(9.16 ± 1.05)(4.01 ± 2.13)。基于受试者工作特征曲线分析,当 NEWS-d 截断值为 7.5 作为估计重新入院的界限值时,灵敏度和特异性分别为 98%和 95%。

结论

NEWS-d 值>7.5 可高度敏感和特异性地识别 ICU 出院患者重新入院的风险。

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