CAJ | 학술논문

目的：了解改良早期预警评分（MEWS)对急诊潜在危重病患者预后预测的适用性和可行性。方法：对急诊2014年2-3月接诊的670例患者进行MEWS评分，追踪所有患者的预后，统计分析MEWS与患者预后的相关性；比较存活、死亡患者的MEWS分值；MEWS分值对患者预后预测分辨度的ROC曲线。结果：MEWS分值与患者预后呈正相关，相关系数为0.47，P<0.05。以死亡为预测指标时，MEWS评分的最佳截断值为7分，灵敏度94%，特异度94%，阳性预测值58%，阴性预测值99%，ROC曲线下面积Az=0.947（95%CI：0.911，0.983）。结论：MEWS对急诊患者预后具有较高程度预测价值，有一定判断潜在危重病患者的能力。MEWS操作简单快捷，费用低廉，可实现对患者病情快速动态评估，适用于急诊患者。
목적：료해개량조기예경평분（MEWS)대급진잠재위중병환자예후예측적괄용성화가행성。방법：대급진2014년2-3월접진적670례환자진행MEWS평분，추종소유환자적예후，통계분석MEWS여환자예후적상관성；비교존활、사망환자적MEWS분치；MEWS분치대환자예후예측분변도적ROC곡선。결과：MEWS분치여환자예후정정상관，상관계수위0.47，P<0.05。이사망위예측지표시，MEWS평분적최가절단치위7분，령민도94%，특이도94%，양성예측치58%，음성예측치99%，ROC곡선하면적Az=0.947（95%CI：0.911，0.983）。결론：MEWS대급진환자예후구유교고정도예측개치，유일정판단잠재위중병환자적능력。MEWS조작간단쾌첩，비용저렴，가실현대환자병정쾌속동태평고，괄용우급진환자。
Objective:To explore the feasibility and applicability of Modiifed Early Warning Score (MEWS) in predicting prognosis of emergency potential critical patients. Methods:The data of 670 outpatient patients were recorded and scored with MEWS between February and March, 2014, and all patients' prognosis (survival, death) were followed up. The correlation of MEWS score and patients prognosis were statistically analyzed. The MEWS scores of survival and death patients were compared as well as area under of ROC curve of MEWS in these indexes. Results:MEWS had a positive correlation with the patient prognosis, the correlation coefifcient was 0.47, and P<0.05. When the death as the predictive index, the best cut-off of MEWS grade was 7, sensitivity 94%, speciifcity 94%, positive predictive value 58%, negative predictive value 99%, the area under the ROC curve:Az=0.947 (95%CI:0.911, 0.983). Conclusion:MEWS have high predictive value of patients' prognosis, and have ability to estimate the severity of the emergency patients. MEWS is suitable for the emergency patients because its grading operation is simple and quick, low cost, and fast dynamic assessment of patient's condition.