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目的:探讨影响上消化道出血（upper gastrointestinal bleeding，UGIB）病情严重程度的影响因素，构建预警评估模型，以列线图的形式呈现，为急诊护士预检分诊提供可行依据。方法:回顾性分析2019年1月至2020年1月温州医科大学附属第一医院急诊科收治的680例UGIB患者，采用随机数字表法分为建模组（510例）和验证组（170例），依据《2020急性上消化道出血急诊诊治流程专家共识》的标准分为高危组和低危组，比较组间各指标差异，多因素Logistic回归分析影响病情严重程度的因素，绘制列线图并验证。结果:呕血（n OR：3.875，95%n CI：2.212~6.79）、糖尿病（n OR：2.64，95%n CI：1.184~5.883）、晕厥（n OR：10.57，95%n CI：3.675~30.403）、心率（n OR：3.262，95%n CI：1.753~6.068）、红细胞分布宽度（n OR：3.904，95%n CI：2.176~7.007）、凝血酶原时间（n OR：3.665，95%n CI：1.625~8.269）、乳酸（n OR：3.498，95%n CI：1.926~6.354）、血红蛋白（n OR：4.984，95%n CI：2.78~8.938）可准确预测UGIB病情严重程度（n P<0.05）。列线图表现出良好的一致性和区分度（C-index=0.903，95%n CI： 0.875~0.931），并经内部验证（C-index=0.895）和Hosmer-Lemeshow拟合优度检验（n P=0.7936）。外部验证C-index为0.899（95% n CI：0.846~0.952），校准曲线提示预警评估模型具有良好稳定性，预测效能优于改良早期预警评分系统（n P<0.05）。n 结论:预警评估模型具有可靠的预测价值，可为急诊医务人员筛查高危患者和制定针对性护理干预措施提供参考依据。“,”Objective:To explore the influencing factors of severity of upper gastrointestinal bleeding (UGIB) and to establish the early warning evaluation model in the form of line chart, so as to provide a feasible basis for emergency nurses\' triage.Methods:A total of 680 UGIB patients admitted to the Emergency Department of the First Affiliated Hospital of Wenzhou Medical University from January 2019 to January 2020 were retrospectively analyzed. They were divided into a modeling group (n n=510) and a validation group (n n=170) by random number table method, and were divided into a high-risk group and a low-risk group according to the expert Consensus on Emergency Diagnosis and Treatment Procedures for Acute Upper Gastrointestinal Bleeding in 2020. The differences of various indicators between groups were compared, the factors affecting the severity of the disease were analyzed by Logistic regression, and the nomogram was drawn and validated.n Results:Multivariate logistic regression analysis showed that hematemesis (n OR=3.875, 95% n CI: 2.212-6.79), diabetes (n OR=2.64, 95% n CI: 1.184-5.883), syncope (n OR=10.57, 95% n CI: 3.675-30.403), heart rate (n OR=3.262, 95% n CI: 1.753-6.068), red blood cell distribution width (n OR=3.904, 95% n CI: 2.176-7.007), prothrombin time (n OR=3.665, 95% n CI: 1.625-8.269), lactic acid (n OR=3.498, 95% n CI: 1.926-6.354) and hemoglobin (n OR=4.984, 95% n CI: 2.78-8.938) were the influencing factors of the severity of UGIB patients (n P < 0.05). The nomogram model showed good consistency and differentiation (C-index=0.903, 95% n CI: 0.875-0.931), and was verified internally (C-index=0.895) and Hosmer-Lemeshow goodness-of-fit test (n P=0.7936). Externally verified C-index was 0.899 (95% n CI: 0.846-0.952). The calibration curve prompt warning evaluation model had good stability and the prediction efficiency was better than the modified early warning score (n P < 0.05).n Conclusions:The early warning evaluation model has a reliable predictive value, which can provide a reference for emergency medical staff to screen high-risk patients and formulate targeted nursing interventions.