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目的探讨改良早期预警评分(Modified Early Warning score,MEWS)与APACHEⅡ评分识别危重症患者的临床对比。方法收集360例死亡患者的相关临床资料-包括性别、年龄、生命体征、意识、化验、诊断等。分别对360例患者同时进行MEWS评分和APACHEⅡ评分。采用spearman等级相关系数衡量APACHEⅡ评分和MEWS评分之间的相关性,MEWS评分的危重症界点的确定采用ROC曲线分析,对MEWS评分在内外科患者之间、不同性别患者之间、不同年龄患者之间的差异比较采用多个独立样本非参数检验。结果 MEWS评分与APACHEⅡ评分显示较好的相关性(p<0.001)。MEWS评分区分危重症患者的可能最佳拟定界点是3分。MEWS评分在内外科患者之间无统计学差异(p>0.05)。MEWS评分不同性别患者之间无统计学差异(p>0.05)。MEWS评分在不同年龄患者之间存在统计学差异(p<0.05)。结论 MEWS评分可能可以替代APACHEⅡ评分应用于临床,以识别危重症患者,但要将年龄因素考虑进去。参数组成包括收缩压、心率、呼吸频率、意识水平、体温5项,判别危重症的阈值≥3分,灵敏度65.9%,特异度86.0%。
Objective To explore the clinical comparison of Modified Early Warning score (MEWS) and APACHE Ⅱ score in the critically ill patients. Methods The clinical data of 360 death patients were collected - including sex, age, vital signs, consciousness, laboratory tests and diagnosis. The MEWS and APACHE II scores were evaluated simultaneously in 360 patients. Spearman rank correlation coefficient was used to measure the correlation between APACHEⅡ score and MEWS score. The critical point of MEWS score was determined by ROC curve analysis. The MEWS score was calculated between surgical patients, different sexes, patients of different ages The differences were compared using multiple independent sample nonparametric tests. Results The MEWS score showed a good correlation with the APACHE II score (p <0.001). The likely best plot point for MEWS scores to distinguish critically ill patients is 3 points. There was no significant difference between MEWS score and surgical patients (p> 0.05). There was no significant difference between MEWS scores in different genders (p> 0.05). MEWS scores were statistically different between patients at different ages (p <0.05). Conclusions The MEWS score may be used in place of the APACHE II score to identify critically ill patients, but age should be taken into account. The parameters included systolic blood pressure, heart rate, respiratory rate, consciousness level and body temperature. The threshold of discriminating critically ill patients was ≥3, the sensitivity was 65.9% and the specificity was 86.0%.