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[目的]比较改良早期预警评分(MEWS)与急性生理与慢性健康状况评分系统(APACHEⅡ)两种评分工具在急诊内科住院病人预后预测的可行性和适用性。[方法]采用前瞻性研究方法,分别对急诊内科住院的640例病人进行APACHEⅡ和MEWS评分,追踪所有病人的预后,比较两种评分预测病人预后的相应预测指标灵敏度、特异度、阳性预测值、阴性预测值和预测预后分辨度的ROC曲线。[结果]在对病人病死危险性的预测能力上,MEWS评分具有较高分辨度。MEWS评分ROC曲线下面积为0.93,APACHEⅡ评分ROC曲线下面积为0.79,差异有统计学意义(Z=4.348,P<0.01)。[结论]MEWS评分和APACHEⅡ评分均可用于判断急诊病人的病情严重程度,对病人病死危险性有一定的预测价值。但MEWS评分因操作简单快捷,可作为APACHEⅡ评分的有益补充。
[Objective] To compare the feasibility and applicability of two scoring tools, improved early warning score (MEWS) and acute physiology and chronic health evaluation system (APACHEⅡ), in prognosis of inpatients in emergency department. [Methods] A total of 640 patients hospitalized in emergency department were evaluated with APACHE Ⅱ and MEWS respectively. The prognosis of all patients was followed up. The sensitivity, specificity and positive predictive value of the corresponding predictors of prognosis were compared between the two kinds of scores. ROC curve of negative predictive value and predictive prognostic resolution. [Results] The MEWS score had a higher resolution in predicting the risk of patient death. The area under the ROC curve of MEWS score was 0.93, and the area under the ROC curve of APACHEⅡscore was 0.79, the difference was statistically significant (Z = 4.348, P <0.01). [Conclusion] The MEWS score and APACHE Ⅱ score can be used to judge the severity of the emergency patients and have some predictive value for the patients’ risk of death. However, the MEWS score is a useful supplement to the APACHE II score due to its quick and easy operation.