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目的:评价国家早期预警评分(NEWS)联合动脉血乳酸对不同类型急诊老年危重症患者死亡预后评估的临床意义。方法:随机选取2013-09-2015-07我院急诊科抢救室的413例老年危重症患者。根据入院诊断分为心血管系统组、呼吸系统组和其他系统组,计算NEWS评分同时检测动脉血乳酸,电话随访患者30d转归并分为存活组和死亡组,采用受试者工作特征曲线(ROC)和Z检验评价NEWS评分、NEWS评分联合动脉血乳酸对各组患者死亡预后的评估价值。结果:NEWS评分对心血管系统组、呼吸系统组和其他系统组危重症患者30d死亡预测的ROC曲线下面积分别是0.781、0.724、0.706;NEWS评分联合动脉血乳酸对3组患者30d死亡预测的ROC曲线下面积分别是0.811、0.758、0.788。结论:NEWS评分联合动脉血乳酸对于不同系统老年危重症患者30d预后评估能力较单纯NEWS评分均有增强。
Objective: To evaluate the clinical significance of the national early warning score combined with arterial blood lactate in assessing the prognosis of death in different types of emergency critical senile patients. Methods: 413 elderly critically ill patients were randomly selected in the emergency room of our hospital from September 2013 to May 2015. According to admission diagnosis, the patients were divided into the cardiovascular system group, respiratory system group and other system groups. The arterial blood lactic acid was measured while calculating the NEWS score. The patients were followed up for 30 days and divided into survival group and death group. The receiver operating characteristic curve (ROC ) And Z test evaluation of NEWS score, NEWS score combined with arterial blood lactate on the prognostic value of the prognosis of patients in each group. Results: The area under the ROC curve of NEWS score for 30-day mortality in cardiovascular system group, respiratory system group and other system group was 0.781,0.724,0.706 respectively; NEWS score combined with arterial blood lactate predicted the 30-day mortality in 3 groups The area under the ROC curve is 0.811, 0.758, 0.788, respectively. Conclusion: NEWS score combined with arterial blood lactate for different systems of elderly critically ill patients 30d prognosis assessment ability than the simple NEWS score were enhanced.