摘要
目的探讨改良早期预警评分及英国国家早期预警评分在恶性血液病化疗后粒细胞缺乏期并发感染患者中的预测价值。方法采用病历回顾性研究的方法,收集符合纳入标准的131例患者资料,按预后及是否转ICU分别进行分组,比较不同分组间2种评分工具的预测效能。结果 2种评分在死亡组、转ICU组中的分值均分别高于存活组、未转ICU组(P<0.05);改良早期预警评分及英国国家早期预警评分预测死亡的ROC曲线下面积分别为0.814、0.866,最佳截断点分别为4、9分,评分表中各生理性指标在存活组与死亡组中的比较差异均有统计学意义(P<0.01);2种评分预测转ICU的ROC曲线下面积分别为0.703、0.692,最佳截断点分别为3、8分,转ICU组与未转ICU组在脉搏或心率、血氧饱和度指标的比较上差异有统计学意义(P=0.002)。结论改良早期预警评分及英国国家早期预警评分在对恶性血液病化疗后粒细胞缺乏期并发感染患者死亡中具有稳定的中等程度预测价值,但在预测转ICU上效能较低,需结合相关的关键性生理指标进行预警评定。
Objective To assess the predictive value of the modified early warning score （MEWS） and national early warning score （NEWS） for hematologic malignancies patients with infection in granulocyte deficiency period of chemotherapy. Methods Retrospective study of medical records were conducted to collect data of 131 patients who met the inclusion criteria. According to the prognosis and whether transferred to ICU, patients were divided into 4 groups and the predictive efficiency of the two scoring tools in different groups was compared. Results The scores of MEWS and NEWS in the death group and the ICU group were higher than those in the survival group and the non-ICU group （P〈0.05）. Regarding the predicted results of death, the area under the ROC curve of MEWS and NEWS was 0.814 and 0.866 respectively and the optimal cut-off points were 4 and 9 respectively. Each physiological index in the two tools had significant differences between the survival group and the death group （P〈0.01）. For predicting whether transferring to ICU or not, the area under the ROC curve of the MEWS and NEWS was 0.703 and 0.692 respectively and the optimal truncation points were 3 and 8 respectively. The comparison between the ICU group and the non-ICU group in the pulse or heart rate and blood oxygen saturation index was significantly different （P=0.002）. Conclusion For hematologic malignancies patients with concurrent infection in granulocyte deficiency period of chemotherapy, MEWS and NEWS demonstrate stably moderate predictive value in the prediction of death, but lower efficacy in predicting the necessity to transfer to the ICU and it is necessary to combine the relevant key physiological indicators to make the prediction.
作者
董玉娇
王爱红
魏素臻
王占聚
肖华
DONG Yu-jiao;WANG Ai-hong;WEI Su-zhen;WANG Zhan-ju;XIAO Hua(School of Nursing,Weifang Medical University,Weifang 261053,China;Dept.of Hematology;Dept.of Nursing Administration;Medical Record Room,the Affiliated Hospital of Weifang Medical University,Weifang 261031,China)
出处
《护理学报》
2018年第17期1-4,共4页
Journal of Nursing（China）
关键词
改良早期预警评分
英国国家早期预警评分
恶性血液病
化疗
粒细胞缺乏期
感染
预测价值
modified early warning score
national early warning score
hematologic malignancies
chemotherapy
granulocyte deficiency
infection
predictive value
