REMS评分对院前急诊患者的评价价值研究
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摘要
目的探讨快速急诊内科评分(REMS)在院前急诊中的价值。方法回顾性分析急救中心收治的创伤患者88例,对患者的格拉斯哥昏迷评分(GCS)、呼吸频率(RR)、血氧饱和度(SPO2)、平均动脉压(MAP)、心率(HR)、年龄等进行REMS评分。结果 88例患者中,59例继续生存,29例死亡。生存患者中,平均年龄为(29.6±10.3)岁,33.9%为女性,34.5%为男性,65.5%为女性,REMS平均得分为(10.2±2.6)分,平均住院时间为(7.6±1.4)d;死亡患者中,平均年龄为(42.4±10.2)岁,66.1%为男性,REMS平均得分为(22.6±5.3)分,平均住院时间为(17.6±5.4)d。通过比较死亡患者REMS分值的分布规律(1~26分),可得出REMS分值越高,所对应的死亡率相应增加(P<0.05)。通过多变量Logistic回归分析得出REMS评分中HR及RR对预测患者死亡率意义不大,GCS评分、SPO2、年龄、MAP是死亡的危险因素(P<0.05)。结论通过REMS评分可以较好地评价院前急诊患者的预后,GCS评分、SPO2、年龄、MAP是导致患者死亡的危险因素。
Objective To explore the clinical value of rapid emergency medicine score( REMS) in the pre-hospital emergency department. Methods 88 patients with trauma were retrospectively collected and analyzed,and the Glasgow Coma Scale( GCS),respiratory rate( RR),oxygen saturation( Sp O2),mean arterial pressure( MAP),heart rate( HR) and age were evaluate with REMS. Results 59 patients were continued to survive,and 29 were died. In survival patients,the average age was( 29. 6 ± 10. 3) years,66. 1% were male,33. 9% were female,the average scores of REMS scores were 10. 2 ± 2. 6,the average hospitalization time were( 7. 6 ± 1. 4) days. In died patients,the average age were( 42. 4 ± 10. 2) years,and 34. 5% were male,and 65. 5% were female,the average scores of REMS were( 22. 6 ±5. 3),mean hospital stay were( 17. 6 ± 5. 4) days. Analyzed the REMS scores distribution of died patients( 1-26 points),the higher of the REMS score,the higher mortality rate( P < 0. 05). By multivariable logistic regression analysis,there were no significance in predicted the mortality,and GCS score,Sp O2,age and MAP were risk factors of death( P <0. 05). Conclusion The REMS score can predict the prognosis of emergency patients,GCS score,Sp O2,age and MAP are the risk factors for death of patients.
Objective To explore the clinical value of rapid emergency medicine score( REMS) in the pre-hospital emergency department. Methods 88 patients with trauma were retrospectively collected and analyzed,and the Glasgow Coma Scale( GCS),respiratory rate( RR),oxygen saturation( Sp O2),mean arterial pressure( MAP),heart rate( HR) and age were evaluate with REMS. Results 59 patients were continued to survive,and 29 were died. In survival patients,the average age was( 29. 6 ± 10. 3) years,66. 1% were male,33. 9% were female,the average scores of REMS scores were 10. 2 ± 2. 6,the average hospitalization time were( 7. 6 ± 1. 4) days. In died patients,the average age were( 42. 4 ± 10. 2) years,and 34. 5% were male,and 65. 5% were female,the average scores of REMS were( 22. 6 ±5. 3),mean hospital stay were( 17. 6 ± 5. 4) days. Analyzed the REMS scores distribution of died patients( 1-26 points),the higher of the REMS score,the higher mortality rate( P < 0. 05). By multivariable logistic regression analysis,there were no significance in predicted the mortality,and GCS score,Sp O2,age and MAP were risk factors of death( P <0. 05). Conclusion The REMS score can predict the prognosis of emergency patients,GCS score,Sp O2,age and MAP are the risk factors for death of patients.
引文
[1]Imhoff BF,Thompson NJ,Hastings MA,et al.Rapid emergency medicine score(REMS)in the trauma population:a retrospective study[J].BMJ Open,2014,4(5):004738.
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[4]王伟力,田丽,王瑛.MEWS、REMS、APACHEⅡ、SAPSⅡ4种评分系统在老年危重患者中的相关性研究及对预后的评估[J].临床荟萃,2013,30(3):253-256.
[5]李亮,任艺,邵旦兵,等.SIRS评分、REMS评分和APACHEⅡ评分在急诊危重患者预后评估中的对比研究[J].临床急诊杂志,2014,15(5):248-250.
[6]刘家炜,王连馥,陈冬琴.快速急诊内科评分在急诊科中的应用[J].中国临床医生,2014,42(11):67-69.
[7]Bulut M,Cebicci H,Sigirli D,et al.The comparison of modified early warning score with rapid emergency medicine score:a prospective multicentre observational cohort study on medical and surgical patients presenting to emergency department[J].Emergency Medicine Journal,2014,31(6):476-481.
[8]邓旭军,樊莉.REMS评分系统在院前急救中的应用研究[J].新疆医学,2015,45(11):1613-1615.
[9]王长远,曹涛,朱丹丹,等.REMS评分对急诊老年严重脓毒症患者预后的评估价值[J].临床误诊误治,2014,27(1):4-6.
[2]任艺,邵旦兵,刘红梅,等.简单临床评分在急诊抢救室中的应用价值[J].中华急诊医学杂志,2012,21(9):1012-1015.
[3]冉果,杨起,仝慧茹.MEWS评分和REMS评分在急性冠脉综合征病情评估和分诊中的对比研究[J].中西医结合心血管病杂志:电子版,2014,2(10):7-8.
[4]王伟力,田丽,王瑛.MEWS、REMS、APACHEⅡ、SAPSⅡ4种评分系统在老年危重患者中的相关性研究及对预后的评估[J].临床荟萃,2013,30(3):253-256.
[5]李亮,任艺,邵旦兵,等.SIRS评分、REMS评分和APACHEⅡ评分在急诊危重患者预后评估中的对比研究[J].临床急诊杂志,2014,15(5):248-250.
[6]刘家炜,王连馥,陈冬琴.快速急诊内科评分在急诊科中的应用[J].中国临床医生,2014,42(11):67-69.
[7]Bulut M,Cebicci H,Sigirli D,et al.The comparison of modified early warning score with rapid emergency medicine score:a prospective multicentre observational cohort study on medical and surgical patients presenting to emergency department[J].Emergency Medicine Journal,2014,31(6):476-481.
[8]邓旭军,樊莉.REMS评分系统在院前急救中的应用研究[J].新疆医学,2015,45(11):1613-1615.
[9]王长远,曹涛,朱丹丹,等.REMS评分对急诊老年严重脓毒症患者预后的评估价值[J].临床误诊误治,2014,27(1):4-6.