简单临床评分在急诊抢救室中的应用价值(1)
【摘要】目的 探讨简单临床评分(simple clinical score，SCS)在急诊抢救室中的临床应用价值。方法 对2011年7月1日至8月31日收入南京军区南京总医院急诊抢救室的655例危重症患者，通过分析SCS评分与患者实际结局的关系，以及SCS各项指标与死亡风险的相关关系，评估在急诊抢救室使用SCS评分系统的临床价值。结果 655例患者中，SCS评分越高者，死亡危险率越高，不同分值的SCS评分分组之间的死亡危险率差异有统计意义(P <0.01)，不同组别间的各项指标，除“体温、不能独自站立或需要家庭护理”之外，其余各项指标在组间差异有统计学意义(P <0.05)。SCS评分各指标二分类logistic回归分析结果显示，年龄、糖尿病、昏迷、脉搏、收缩压、呼吸频率，这6项与患者病死率有显著相关性。结论 SCS评分系统适合在急诊抢救室对危重患者做出正确的评价。在急诊抢救过程中，年龄、糖尿病、昏迷、脉搏、收缩压、呼吸频率，这6项需要重点关注，以利于改善患者预后。
【关键词】急诊抢救室；简单临床评分系统；χ2检验；二分类logistic回归分析
, 百拇医药
The application value of SCS scoring system in emergency departmentREN Yi， SHAO Dan—bing， LIU Hong—mei， ZHANG Wei， XU Bao—hua， TANG Wen—jie， QIAN Jian， YANG Zhi—zhou， SUN Bao—di， SUN Lin， NIE Shi—nan. Emergency Department， Nanjing General Hospital of Nanjing Military Command， Nanjing 210002， China
Corresponding author： NIE Shi—nan ， Email：shn_nie@sina.com
【Abstract】Objective To investigate the clinical value of the simple clinical score(SCS)in Emergency Department. Methods A total of 655 patients with critically illness admitted from July 1， 2011 through August 31， 2011 were enrolled to evaluate the clinical application of SCS in emergency rescue room by analysis of the relationship between SCS and outcome of patients， and the correlation between each factor of SCS and the risk of death.Results The higher SCS， the higher hazard ratio for death. Differences in the hazard ratio for death among groups with different scores of SCS were statistical significance ( P <0.01) . According to Chi—square test， there were significant differences in each factor (except body temperature & unable standing or need Home Health Aide) among the groups of SCS(P <0.05). Binary logistic regression analysis of each factor showed that age， diabetes， coma， pulse， systolic pressure and respiratory rate had significant correlation with patient mortality. After logistic regression analysis， age， diabetes， coma， pulse， systolic pressure and respiratory rate are significantly related to the mortality of patients. Conclusions The SCS scoring system is useful to make a precise evaluation of critically ill patients in the emergency department. When emergency rescue is carried out， particular stress should be focused on age， diabetes， coma， pulse， systolic pressure and respiratory rate.
, http://www.100md.com
【Key words】Emergency department；Simple clinical score(SCS)；A chi—square test； Binary classification logistic regression analysis
急诊抢救室危重患者云集，病情瞬息万变，意外事件时有发生。如何能够在早期识别意外发生的“预警信号”[1]，对死亡风险较高的患者进行早期临床干预，以阻止病情恶化[2]，是急诊科医务工作者的一项重要任务。简单临床评分(simple clinical score，SCS)是由爱尔兰学者Kellett和Deane[3]于2006年首次提出的，仅在急诊患者中应用的一种预测病情预后的指标。该评分系统通过年龄、收缩压、体温等14项临床中简单、易得的指标评分，得出SCS评分，从而预测患者的预后情况。它的优点在于：参数易获得性、资料采集的准确性和及时性，在评估预后时不受疾病诊断的影响。该评分系统在国内急诊科目前尚未普遍应用，文献也鲜有报道。考虑到国内外患者的个体差异，疾病谱的地区差异，本研究对2011年7—8月南京军区南京总医院急诊科抢救室收治的655例危重症患者，按SCS评分系统搜集资料进行分析，并根据患者SCS评分，将患者危险程度分为5组[3]，比较各组死亡危险率，并且将每项评分标准与患者预后进行分析，从而探讨SCS评分系统在国内急诊抢救室的使用价值。, http://www.100md.com(任艺 邵旦兵 刘红梅 张炜 许宝华 唐文杰 钱健 杨志洲 孙宝迪 孙琳 聂时南)
【关键词】急诊抢救室；简单临床评分系统；χ2检验；二分类logistic回归分析
, 百拇医药
The application value of SCS scoring system in emergency departmentREN Yi， SHAO Dan—bing， LIU Hong—mei， ZHANG Wei， XU Bao—hua， TANG Wen—jie， QIAN Jian， YANG Zhi—zhou， SUN Bao—di， SUN Lin， NIE Shi—nan. Emergency Department， Nanjing General Hospital of Nanjing Military Command， Nanjing 210002， China
Corresponding author： NIE Shi—nan ， Email：shn_nie@sina.com
【Abstract】Objective To investigate the clinical value of the simple clinical score(SCS)in Emergency Department. Methods A total of 655 patients with critically illness admitted from July 1， 2011 through August 31， 2011 were enrolled to evaluate the clinical application of SCS in emergency rescue room by analysis of the relationship between SCS and outcome of patients， and the correlation between each factor of SCS and the risk of death.Results The higher SCS， the higher hazard ratio for death. Differences in the hazard ratio for death among groups with different scores of SCS were statistical significance ( P <0.01) . According to Chi—square test， there were significant differences in each factor (except body temperature & unable standing or need Home Health Aide) among the groups of SCS(P <0.05). Binary logistic regression analysis of each factor showed that age， diabetes， coma， pulse， systolic pressure and respiratory rate had significant correlation with patient mortality. After logistic regression analysis， age， diabetes， coma， pulse， systolic pressure and respiratory rate are significantly related to the mortality of patients. Conclusions The SCS scoring system is useful to make a precise evaluation of critically ill patients in the emergency department. When emergency rescue is carried out， particular stress should be focused on age， diabetes， coma， pulse， systolic pressure and respiratory rate.
, http://www.100md.com
【Key words】Emergency department；Simple clinical score(SCS)；A chi—square test； Binary classification logistic regression analysis
急诊抢救室危重患者云集，病情瞬息万变，意外事件时有发生。如何能够在早期识别意外发生的“预警信号”[1]，对死亡风险较高的患者进行早期临床干预，以阻止病情恶化[2]，是急诊科医务工作者的一项重要任务。简单临床评分(simple clinical score，SCS)是由爱尔兰学者Kellett和Deane[3]于2006年首次提出的，仅在急诊患者中应用的一种预测病情预后的指标。该评分系统通过年龄、收缩压、体温等14项临床中简单、易得的指标评分，得出SCS评分，从而预测患者的预后情况。它的优点在于：参数易获得性、资料采集的准确性和及时性，在评估预后时不受疾病诊断的影响。该评分系统在国内急诊科目前尚未普遍应用，文献也鲜有报道。考虑到国内外患者的个体差异，疾病谱的地区差异，本研究对2011年7—8月南京军区南京总医院急诊科抢救室收治的655例危重症患者，按SCS评分系统搜集资料进行分析，并根据患者SCS评分，将患者危险程度分为5组[3]，比较各组死亡危险率，并且将每项评分标准与患者预后进行分析，从而探讨SCS评分系统在国内急诊抢救室的使用价值。, http://www.100md.com(任艺 邵旦兵 刘红梅 张炜 许宝华 唐文杰 钱健 杨志洲 孙宝迪 孙琳 聂时南)