Comparative research on the prognostic ability of improved early warning and APACHE II evaluation for hospitalized patients in the emergency department

Yan-Mei Wang , Ting-Ting Wei , Ming Hou , Li Zhang , Aziguli· Maimaiti , Ping Li
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引用次数: 4

Abstract

Objective

To compare the feasibility and applicability of predicting the prognosis of patients using the Early Warning Score (MEWS) system and the Acute Physiology and Chronic Health Evaluation (APACHE II) system in the Emergency Department.

Methods

Using a prospective study method, the APACHE II and MEWS data for 640 patients hospitalized in the Emergency Internal Medicine Department were collected. The prognoses, two scores to predict the corresponding prediction index of sensitivity, specificity and positive predictive value for the prognosis, the negative predictive value and the ROC curve for predicting the prognosis were analyzed for all patients.

Results

In the prediction of the risk of mortality, the MEWS system had a high resolution. The MEWS area under the ROC curve was 0.93. The area under the ROC curve for the APACHE score was 0.79, and the difference was statistically significant (Z = 4.348, P < 0.01).

Conclusions

Both the MEWS and APACHE II systems can be used to determine the severity of emergency patients and have a certain predictive value for the patient's mortality risk. However, the MEWS system is simple and quick to operate, making it a useful supplement for APACHE II score.

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改进预警与APACHEⅱ评价对急诊科住院患者预后能力的比较研究
目的比较早期预警评分(MEWS)系统与急性生理与慢性健康评估(APACHE II)系统在急诊科预测患者预后的可行性和适用性。方法采用前瞻性研究方法,收集640例急诊科住院患者的APACHE II和MEWS资料。对所有患者的预后、预测相应预测指标敏感性、特异性和阳性预测值的两个评分、预测预后的阴性预测值和预测预后的ROC曲线进行分析。结果MEWS系统在预测死亡风险方面具有较高的分辨率。ROC曲线下的MEWS面积为0.93。APACHE评分的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和APACHEⅱ系统均可用于判断急诊患者的严重程度,对患者的死亡风险有一定的预测价值。然而,MEWS系统操作简单、快捷,使其成为APACHE II评分的有用补充。
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