早期预警评分系统NEWS和MEWS在COPD急性加重中的作用

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.1177/11795484231152305
Christina Triantafyllidou, Petros Effraimidis, Konstantinos Vougas, Jonas Agholme, Mirjam Schimanke, Karin Cederquist
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引用次数: 2

摘要

慢性阻塞性肺疾病(AECOPD)急性加重是该疾病病程中最具破坏性的事件。我们的目的是探讨预警评分系统:国家预警评分(NEWS)和修改预警评分(MEWS)在AECOPD中的价值。这是一项对住院的AECOPD患者的前瞻性观察研究。在入院时(NEWS-d1, MEWS-d1)和第二天(NEWS-d2, MEWS-d2)登记NEWS和MEWS评分。取鼻咽及痰标本进行培养。随访时间分别为住院后3、6个月。探讨NEWS和MEWS与COPD其他参数之间可能存在的相关性。纳入了64例患者。住院死亡率为4.7%,而6个月总死亡率为26%。我们没有发现住院死亡率与任何评分之间有任何显著的相关性,但我们可以显示,在6个月的随访中,NEWS-d2较高的患者死亡率更高,AECOPD更频繁。NEWS-d2与出现时较高的pCO2和更频繁地使用NIV相关。NEWS-d1和NEWS-d2越高,住院时间越长。鼻咽样本中病原体的存在与第二天两项得分的较高降低有关。因此,我们支持NEWS评价住院AECOPD患者的优越性。住院第二天的NEWS仍然很高,这表明高碳酸血症的风险很高,需要使用NIV,但在AECOPD后6个月,死亡率更高,病情加重更频繁。
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The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPD.

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are the most devastating events in the course of the disease. Our aim was to investigate the value of early warning scoring systems: National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) in AECOPD. This is a prospective observational study of patients with AECOPD who were admitted at hospital. The NEWS and MEWS scores were registered at admission (NEWS-d1, MEWS-d1) and on the second day (NEWS-d2, MEWS-d2). A nasopharyngeal and sputum sample was taken for culture. Follow-up was done at 3 and 6 months after hospitalization. Any possible correlations between NEWS and MEWS and other parameters of COPD were explored. A cohort of 64 patients were included. In-hospital mortality was 4.7% while total mortality at 6 months was 26%. We did not find any significant correlation between in-hospital mortality and any of the scores but we could show a higher mortality and more frequent AECOPD at 6 months of follow-up for those with higher NEWS-d2. NEWS-d2 was associated with higher pCO2 at presentation and a more frequent use of NIV. Higher NEWS-d1 and NEWS-d2 were predictive of a longer hospital stay. The presence of pathogens in the nasopharyngeal sample was related with a higher reduction of both scores on the second day. We therefore support the superiority of NEWS in the evaluation of hospitalized patients with AECOPD. A remaining high NEWS at the second day of hospital stay signals a high risk of hypercapnia and need of NIV but also higher mortality and more frequent exacerbations at 6 months after AECOPD.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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