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目的:本文采用SAPSⅡ与MEWS评分系统作比较,为的是验证MEWS评分方法在临床上应用价值。方法:193例住院患者在入院24h内分别作SAPSⅡ与MEWS评分,及不同分数段构成比、和不同方法的分辨力、鉴别能力一致性分析,并对所有患者均作终点观察。结果:MEWS评分在3分以上自动出院/死亡、转上级医院抢救患者比例明显增加,与2分以下的比较具有统计学意义(P<0.01),MEWS评分对自动出院/死亡、转上级医院抢救鉴别敏感性79.6%、特异性71.5%。SAPSⅡ评分在25分以上自动出院/死亡、转上级医院抢救患者与24分以下比较有统计学意义(P<0.01),SAPSⅡ对自动出院/死亡、转上级医院抢救鉴别敏感性79.6%,特异性66.0%。2种评分方法分辨力其ROC曲线下面积MEWS0.823、SAPSⅡ0.802均具有较高分辨力及鉴别能力分析中其Kaapa值为MEWS0.499、SAPSⅡ0.511。结论:EWS、SAPSⅡ2种评分系统均可用于判断危重患者的病情预后预测,有一定识别潜在危重患者的能力。但是,MEWS因其快速、简便、费用较低和便于操作等优点,更适用于急症科和基层医院。
Aims: In this paper, SAPS Ⅱ and MEWS scoring system for comparison, in order to verify the MEWS score in the clinical application of value. Methods: 193 hospitalized patients were admitted to hospital for 24h SAPS Ⅱ and MEWS scores, and different scores of constituent ratio, and different methods of resolution, the ability to identify the consistency analysis, and all patients were as the end point of observation. Results: The MEWS score was automatically discharged / died at least 3 points, and the proportion of rescuing patients in superior hospitals was significantly increased (P <0.01). The MEWS score was higher in patients discharged from hospital / death and transferred to superior hospitals The differential sensitivity was 79.6% and the specificity was 71.5%. The SAPSⅡ score was automatically discharged / died at 25 points or more, and the patients who were rescued from the superior hospital had a statistically significant difference (P <0.01), the SAPSⅡwas 79.6% sensitive to the automatic discharge / death and transferred to the superior hospital 66.0%. The resolution of the two methods showed that the area under ROC curve of MEWS0.823 and SAPSⅡ0.802 were both high resolution and their discriminative power was MEWS0.499 and SAPSⅡ0.511. Conclusion: Both EWS and SAPS Ⅱ scoring systems can be used to predict the prognosis of critically ill patients, and have the ability to identify potentially critical patients. However, MEWS is more suitable for emergency and primary care hospitals because of its quickness, simplicity, low cost and ease of operation.