【摘要】 目的:探讨改良早期预警(MEWS)评分与急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分应用于重症医学科患者病情预测的效果。方法:65例急危重症患者分为死亡组(30例)和存活组(35例),以入科2h为观察起点,收集相关数据,并进行MEWS和APACHEⅡ评分,以入科90d作为观察终点,终点结局是否死亡作为观察指标。分析不同评分系统的预测指标,并对其进行比较和评价。结果:死亡组MEWS评分和APACHEⅡ评分均明显高于存活组,P<0.05。MEWS评分对重症医学科患者死亡的预测评分界值为5分,灵敏度为0.833,特异度为0.886,ROC曲线下面积为0.890。APACHEⅡ评分对重症医学科患者死亡的预测评分界值为16分,灵敏度为0.933,特异度为0.829,ROC曲线下面积为0.900;MEWS评分较APACHEⅡ评分相比差异不明显。结论:MEWS评分可作为重症医学科对患者病情的预测,较APACHEⅡ评分系统简单,操作方便。更多还原

【Abstract】 Objective: To study the prediction value of modified early warning score(MEWS) and acute physiology and chronic evaluation Ⅱ(APACHE Ⅱ) score for death of the patients in intensive care unit. Methods:Patients who were admitted to intensive care unit during January 2015 to January 2016 staying exceeding 2 hours were enrolled for this study. The MEWS score and APACHE Ⅱ score were assessed from the beginning time to the endpoint. Then the predication indexes were analyses and compared. Results:Both the MEWS score and the APACHE Ⅱ score of the death group were higher than those in the survivors. In prediction of death, the cut-off value score was 5, the sensitivity was 0.833, the specificity was 0.886 and the area under curve(AUC) was 0.890 by MEWS score. While for APACHE Ⅱ score, the cut-off value score was 16, the sensitivity was 0.933, the specificity was 0.829 and the area under curve(AUC) was 0.900. Conclusion:As APACHE Ⅱ score, the MEWS score could be used as a useful index to predict the intensive care unit patients in clinical practice.更多还原