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
Turk J Med Sci. 2020 Aug 26;50(5):1203-1209. doi: 10.3906/sag-1906-78.
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.
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.
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.
A NEWS-d value of >7.5 demonstrated high sensitivity and specificity in identifying the risk of readmission for patients being discharged from ICU.
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。
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。
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%。
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。