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目的:探讨循环、呼吸、胸腹、运动、语言评分(CRAMS)记分法在急诊创伤患者病情评估及死亡预测中临床应用价值。方法:对2013年至2014年间由我院救治的1 308例急诊创伤性患者分别进行CRAMS评分及损伤严重度评分(ISS),比较两者在死亡预测结果以及ROC曲线线下面积上差异,同时对各组评分系统常用指标及轻、重症患者死亡预测情况进行比较。结果:1 308例患者中死亡69例,死亡率5.28%,死亡患者CRAMS评分(5.72±0.43)分及ISS评分(23.42±3.29)分均与存活组CRAMS评分(6.07±0.21)分及ISS(19.44±3.74)分差异有统计学意义;CRAMS评分及ISS ROC线下面积分别为0.911、0.871,两者间差异有统计学意义(P<0.05);此外,CRAMS评分灵敏度高于ISS,差异有统计学意义(P<0.05),但在特异性、准确度以及预测轻重症死亡情况上差异无统计学意义。结论:CRAMS评分及ISS对急诊创伤患者病情评估及死亡预测具有一定指导意义,其中CRAMS评分因其具有操作简便、可信度高等优点而更具有临床应用价值。
Objective: To investigate the clinical value of CRAMS score in assessing the condition of emergency trauma patients and predicting mortality. Methods: The CRAMS score and severity of injury score (ISS) of 1 308 acute traumatic patients treated in our hospital from 2013 to 2014 were compared. The differences between the predicted results of death and the area under the ROC curve were compared. Meanwhile, Common indicators of each group scoring system and light and severe cases of death were compared. Results: Among 308 patients, 69 cases were dead and the death rate was 5.28%. CRAMS score (5.72 ± 0.43) and ISS score (23.42 ± 3.29) were significantly correlated with CRAMS score (6.07 ± 0.21) and ISS ( 19.44 ± 3.74). CRAMS score and ISS ROC area were 0.911,0.871, respectively. The difference between the two groups was statistically significant (P <0.05). In addition, the sensitivity of CRAMS score was higher than ISS, the difference was (P <0.05), but there was no significant difference in specificity, accuracy and prediction of severe and severe cases of death. CONCLUSIONS: The CRAMS score and ISS are of guiding significance in assessing the condition and predicting the death of patients with emergency trauma. The CRAMS score is more clinically valuable because of its simple operation and high reliability.