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改良早期预警评分(MEWS)和修订创伤评分(RTS)对急诊创伤患者短期预后的预测价值:一项回顾性研究。

Predictive value of Modified Early Warning Score (MEWS) and Revised Trauma Score (RTS) for the short-term prognosis of emergency trauma patients: a retrospective study.

机构信息

Division of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.

Division of Emergency Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

BMJ Open. 2021 Mar 15;11(3):e041882. doi: 10.1136/bmjopen-2020-041882.

Abstract

OBJECTIVES

This study aimed to assess the predictive value of the Modified Early Warning Score (MEWS) and Revised Trauma Score (RTS) for emergency trauma patients who died within 24 hours.

DESIGN

A retrospective, single-centred study.

SETTING

This study was conducted at a tertiary hospital in Southern China.

PARTICIPANTS

A total of 1739 patients with acute trauma, aged 16 years or older who presented to the emergency department from 1 November 2016 to 30 November 2019, were included.

INTERVENTIONS NONE

None.

OUTCOME

24-hour mortality was the primary outcome of trauma.

RESULTS

1739 patients were divided into the survival group (1709 patients,98.27%), and the non-survival group (30 patients,1.73%). Crude OR and adjusted OR of MEWS were 1.99, 95% CI (1.73 to 2.29), and 2.00, 95% CI (1.74 to 2.31), p<0.001, respectively. Crude OR and adjusted OR of RTS were 0.62, 95% CI (0.55 to 0.69) and 0.61, 95% CI (0.55 to 0.68), p<0.001, respectively. The area under the curve of MEWS was significantly higher than that of RTS (p=0.005): 0.927, 95% CI (0.914 to 0.939) vs 0.799, 95% CI (0.779 to 0.817).

CONCLUSIONS

Both MEWS and RTS were independent predictors of the short-term prognosis in emergency trauma patients, MEWS had better predictive efficacy.

摘要

目的

本研究旨在评估改良早期预警评分(MEWS)和修订创伤评分(RTS)对 24 小时内死亡的急诊创伤患者的预测价值。

设计

回顾性、单中心研究。

地点

本研究在华南地区的一家三级医院进行。

参与者

共纳入 2016 年 11 月 1 日至 2019 年 11 月 30 日期间因急性创伤就诊于急诊科、年龄在 16 岁及以上的 1739 例患者。

干预措施

无。

结局

24 小时死亡率是创伤的主要结局。

结果

1739 例患者分为存活组(1709 例,98.27%)和非存活组(30 例,1.73%)。MEWS 的粗比值比和调整比值比分别为 1.99,95%CI(1.73 至 2.29)和 2.00,95%CI(1.74 至 2.31),p<0.001。RTS 的粗比值比和调整比值比分别为 0.62,95%CI(0.55 至 0.69)和 0.61,95%CI(0.55 至 0.68),p<0.001。MEWS 的曲线下面积明显高于 RTS(p=0.005):0.927,95%CI(0.914 至 0.939)与 0.799,95%CI(0.779 至 0.817)。

结论

MEWS 和 RTS 均是急诊创伤患者短期预后的独立预测因子,MEWS 具有更好的预测效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08e7/7959230/69dcd7c1724c/bmjopen-2020-041882f01.jpg

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