REMS评分和APACHEⅡ评分对急诊内科抢救室患者的评估价值
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摘要
目的探究快速急诊内科评分(REMS)和急性生理及慢性健康状况(APACHEⅡ)评分对急诊内科抢救室患者的评估价值。方法研究对象选取我院急诊内科抢救室2016年1月至2017年5月收治的386例患者,根据患者预后情况将其分为病死组(38例)和存活组(348例),均行REMS及APACHEⅡ评分。比较两种评分的评估价值。结果病死组的REMS、APACHEⅡ评分均明显高于存活组(P<0.01);REMS≥16分的患者病死率及APACHEⅡ评分均明显高于REMS评分<6分(P<0.05),且APACHEⅡ评分随REMS评分的升高而升高(r=0.906,P<0.05);APACHEⅡ评分预测入住ICU患者的ROC曲线下面积、灵敏度及特异度明显高于REMS评分(P<0.05)。结论 REMS及APACHEⅡ评分用于判断患者病情均有一定的评估价值,其中REMS评分能更迅速地评估患者早期病情,有助于提高临床抢救率,值得推广。
Objective To explore the evaluation value of rapid emergency medicine score(REMS) and acute physiological and chronic health conditions(APACHE Ⅱ) score in patients of emergency internal medicine rescue room.Methods A total of 386 patients admitted in emergency internal medicine rescue room of our hospital from January 2016 to May 2017 were selected as study objects and divided into death group(38 cases) and survival group(348 cases) according to the prognosis of the patients, All the patients acquired REMS and APACHE II score. The evaluation value of the two kinds of scores were compared and analyzed. Results REMS and APACHE Ⅱ scores in the dead group were significantly higher than those in the survival group(P<0.01); the mortality and APACHE II scores in patients with REMS ≥16 score were significantly higher than those in patients with REMS<6 score(P<0.05); APACHEⅡscore increased with the increase of REMS score(r =0.906, P <0.05). The area under the ROC curve, the sensitivity and specificity of APACHE II score predicted the ICU patients were significantly higher than those of REMS score(P<0.05). Conclusion REMS and APACHEⅡ score in patient's condition have certain value of evaluation, and REMS score can more quickly assess the patient's early condition, help to improve the clinical rescue rate, which is worth promoting.
Objective To explore the evaluation value of rapid emergency medicine score(REMS) and acute physiological and chronic health conditions(APACHE Ⅱ) score in patients of emergency internal medicine rescue room.Methods A total of 386 patients admitted in emergency internal medicine rescue room of our hospital from January 2016 to May 2017 were selected as study objects and divided into death group(38 cases) and survival group(348 cases) according to the prognosis of the patients, All the patients acquired REMS and APACHE II score. The evaluation value of the two kinds of scores were compared and analyzed. Results REMS and APACHE Ⅱ scores in the dead group were significantly higher than those in the survival group(P<0.01); the mortality and APACHE II scores in patients with REMS ≥16 score were significantly higher than those in patients with REMS<6 score(P<0.05); APACHEⅡscore increased with the increase of REMS score(r =0.906, P <0.05). The area under the ROC curve, the sensitivity and specificity of APACHE II score predicted the ICU patients were significantly higher than those of REMS score(P<0.05). Conclusion REMS and APACHEⅡ score in patient's condition have certain value of evaluation, and REMS score can more quickly assess the patient's early condition, help to improve the clinical rescue rate, which is worth promoting.
引文
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[2]熊明英.改良早期预警评分与APACHEⅡ预测急诊室患者病情的效果分析[J].临床急诊杂志,2015,22(10):798-800.
[3]陈莉,邓立普,赵红梅,等.NEWS、REMS和APACHEⅡ评分对急诊危重患者预后评估的对比研究[J].中华危重病急救医学,2017,29(12):1092-1096.
[4]李慧珍,张海英,赵艳伶.APACHEⅡ评分引入MODS评分系统对ICU危重症患者预后的预测价值[J].河北医学,2017,23(4):568-572.
[5]梁镰静,秦溱,胡海,等.改良早期预警评分系统对老年休克患者预后的预测价值[J].临床急诊杂志,2017,9(3):208-212.