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目的通过分析快速急诊医学评分(REMS)与反映护理工作量的治疗干预计分系统(TISS-28)的相关性,探讨REMS快速预估地震危重伤员需要的护理工作量的可行性,为地震伤员快速有效的医疗资源配置提供依据。方法回顾性选取四川大学华西医院2013年4月20日-27日接收的芦山地震伤员中,急性生理与慢性健康评分Ⅱ评分>25分的危重伤员。共纳入芦山地震重症伤员39例,其中男24例(61.5%),女15例(38.5%);年龄5~90岁,平均(57.1±19.8)岁。分别计算危重伤员的REMS评分和TISS-28评分;再分析两者是否有相关性;如有,将上述评分分别带入二次曲线模型、复合曲线模型、线性模型、对数曲线模型、三次曲线模型、生长曲线模型和指数曲线模型等模型,找出最适合描述REMS评分与TISS-28评分相关关系的曲线回归方程。结果 REMS评分与TISS-28评分呈正相关(rs=0.710,P<0.001)。在各曲线模型中,最适合描述REMS评分与TISS-28评分关系者为对数曲线模型,两者的最适曲线回归方程可用TISS=-5.946+4.467 ln REMS。结论地震伤员的REMS评分能较好地快速预估地震伤员需要的护理工作量,通过对数曲线模型得出的曲线回归方程,能用REMS快速预估TISS-28,为合理指导医疗资源配置提供依据。
Objective To explore the feasibility of using REMS to rapidly estimate the nursing workload needed by critically injured earthquake victims by analyzing the correlation between rapid medical emergency score (REMS) and therapeutic intervention score system (TISS-28) reflecting nursing workload. Rapid and effective provision of medical resources to provide the basis. Methods Retrospectively selected critically ill wounded patients with Acute Physiological and Chronic Health Scale Ⅱ score> 25 points received by Huaxi Hospital of Sichuan University from April 20 to April 27, 2013. There were 39 cases of severe casualties in Lushan earthquake, including 24 males (61.5%) and 15 females (38.5%), ranging in age from 5 to 90 years with an average of 57.1 ± 19.8 years. The REMS score and TISS-28 score of critically ill patients were calculated respectively, and then analyzed whether there was a correlation between them. If so, the above scores were respectively taken into quadratic curve model, compound curve model, linear model, logarithmic curve model, cubic curve Model, growth curve model and exponential curve model to find the most suitable regression equation to describe the correlation between REMS score and TISS-28 score. Results REMS score was positively correlated with TISS-28 score (rs = 0.710, P <0.001). In each curve model, the most suitable for describing the relationship between REMS score and TISS-28 score logarithmic curve model, the optimal curve regression equation between the two available TISS = -5.946 + 4.467 ln REMS. Conclusion The REMS score of the earthquake casualty can predict the amount of nursing work required by earthquake casualty rapidly. The curve regression equation obtained by logarithmic curve model can be used to quickly estimate TISS-28 with REMS to provide reasonable guidance for medical resource allocation in accordance with.