摘 要: 目的 探讨改良早期预警评分(modified early warning score, MEWS)对高海拔地区多发伤患者伤重度和死亡风险的预测价值。方法 收集51例多发伤患者临床资料,评估入院时MEWS分值,在完善各项检查后依据损伤严重度评分(injury severity score,ISS)分为轻伤组(<16分)和重伤组(≥16分),根据医疗结果分为生存组和死亡组, 比较轻重伤患者和生存及死亡患者 MEWS 的差异。采用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)评价 MEWS,判断多发伤患者伤情和预后的准确性。 结果 轻伤组与重伤组 MEWS分值分别为(2. 63±2. 00)和(6. 53±3. 36),差异有统计学意义(P<0. 05);MEWS多发伤伤重度ROC曲线下面积(AUC)为(0. 839±0. 070,P<0. 05)。生存组与死亡组患者初始MEWS分值分别为(4. 84±2. 07)和(9. 38±3. 50),差异有统计学意义(P<0. 05);MEWS多发伤患者死亡风险预测AUC为(0. 834±0. 069,P<0. 05)。结论 MEWS有助于对多发伤患者伤重度及死亡风险作出准确判断,MEWS>4可作为重度多发伤的判断标准,MEWS>9提示多发伤患者具有死亡风险。 |
关键词: 改良早期预警评分(MEWS) 多发伤 伤重度和死亡风险预测 损伤严重度评分(ISS) 受试者工作特征曲线(ROC 曲线) |
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Practicability of MEWS in judging condition of multiple injuries and predicting death at high altitude area |
JIANG Xiao-bin,LIU Rong-ping,CHANG Yun-xian,LU Yun-huai,DONG Yun-xiang,XU Shou-jiang
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Emergency Department of Shanghai Ninth People’s Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China
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Abstract: Objective To investigate the practicability of MEWS (modified early warning score) for assessing injury severity and predicting death risk of patient with multiple injuries following trauma in high altitude area. Methods The clinical data of 51 patients with multiple injuries following trauma were collected to assess MEWS. According to the injury severity score (ISS),the subjects were divided into mild group (ISS<16) and severe group (ISS≥16), compare the difference of the MEWS among mild group, severe group, survivor group and death group. Additionally, the receiver operating characteristic curve ( ROC curve) was also used to evaluate the utility of MEWS for assessing injury severity and predicting outcome of the patients. Results The results showed that the difference of MEWS between mild and severe groups was significant (2. 63±2. 00 vs. 6. 53±3. 36,P<0. 05), the AUC of MEWS in severe group was 0. 839±0. 070 (P<0. 05), and the primary MEWS in survivor and death group were 4. 84±2. 07 and 9. 38±3. 50, respectively (P<0. 05), and the AUC of MEWS for predicting mortality was 0. 834±0. 069 (P<0. 05) . Conclusion The results suggested that MEWS was useful for accurately assessing injury severity and predicting mortality of patients with multiple injuries following trauma, MEWS over 4 may suggest severe condition of injury, and MEWS over 9 often indicated a poor prognosis. |
Keywords: modified early warning score(MEWS) multiple injuries prediction of injury severity and mortality risk injury severity score(ISS) receiver operating characteristic curve(ROC curve) |