【摘要】 目的 比较改良早期预警评分、重要性早期预警评分和国家早期预警评分对急性胸痛患者在急诊发生心肺功能衰竭的预测效能及分层能力。方法 回顾性调查2020年3月至2021年6月在某三级甲等医院急诊科就诊的4 598例急性胸痛患者，根据其是否发生心肺功能衰竭分组，比较组间的改良早期预警评分、重要性早期预警评分和国家早期预警评分，采用受试者工作特征曲线下面积评价其预测效能。结果 改良早期预警评分、重要性早期预警评分和国家早期预警评分预测心肺功能衰竭的AUC为0.747、0.866、0.863，其中重要性早期预警评分与国家早期预警评分未存在显著差异（P>0.05）；最佳截断值分别为1.5、4.5、4.5，相应的灵敏度和特异度分别为0.709、0.835、0.777和0.697、0.758、0.815。结论 重要性早期预警评分预测急性胸痛患者心肺功能衰竭风险的价值更高，其界值水平和高灵敏度特点对风险分层更为合理，有助于指导预检分诊和分级护理。更多还原

【Abstract】 Objective To compare the predictive efficacy and stratification ability of Modified Early Warning Score(MEWS),VitalPac Early Warning Score(ViEWS) and National Early Warning Score(NEWS) on the occurrence of cardiopulmonary failure in patients with acute chest pain in emergency department.Methods A retrospective survey was conducted on 4 598 patients with acute chest pain in the emergency department of a class A tertiary hospital from March 2020 to June 2021.Based on whether cardiopulmonary failure occurred or not,MEWS,ViEWS and NEWS were compared and the area under ROC Curve(AUC) was used to evaluate their predictive efficacy.Results The AUC of MEWS,ViEWS and NEWS in pridicting cardiopulmonary failure were 0.747,0.866,0.863 and there was no significant difference between ViEWS and NEWS(P>0.05). Best cutoff value were 1.5,4.5,4.5 respectively. The corresponding sensitivity and specificity were 0.709,0.835,0.777 and 0.697,0.758,0.815 respectively.Conclusion ViEWS has a higher predictive value on cardiopulmonary failure.Its cut-off value level and the characteristic of high sensitivity are more reasonable for risk stratification and more conducive to guiding pre-examination triage and grading nursing.更多还原