摘要
目的探讨两种早期预警评分系统对急性冠状动脉综合征患者发生心搏骤停的预测效果。方法采取回顾性病例-对照研究,便利选取2018年12月至2022年12月因急性冠状动脉综合征入某医院急诊科进行治疗的300例患者作为研究对象,按入院24 h后是否发生心搏骤停分为病例组(158例)和对照组(142例)。病例组收集患者在心搏骤停发生前30 min、1 h、2 h、4 h、8 h、16 h、24 h的生命体征,并带入改良早期预警评分量表和重要性早期预警评分量表;对照组随机选择24 h内具有完整资料的时间点与病例组相对应,收集内容及方法同病例组。结果病例组患者心搏骤停前30 min至24 h各个时间点,两个量表评分均明显高于对照组(P<0.05)。心搏骤停前8 h,改良早期预警评分的ROC曲线下面积为0.642,具有较低的预测效能,重要性早期预警评分的ROC曲线下面积为0.783,预测效能中等。心搏骤停发生前的8 h内,重要性早期预警评分的ROC曲线下面积均>0.7,且各值比较差异均无统计学意义(P>0.05)。重要性早期预警评分对各种类型的急性冠状动脉综合征患者发生心搏骤停的ROC曲线下面积均>0.7。结论重要性早期预警评分比改良早期预警评分具有更高的预测效能,能够提前8 h预测心搏骤停的发生,且对各种类型的急性冠状动脉综合征患者均有良好的预测效果,建议临床推广应用。
Objective To explore the predictive effect of two early warning scoring systems on cardiac arrest in patients with acute cor⁃onary syndrome.Methods A retrospective case-control study was conducted to conveniently select 300 patients who were admitted to the e⁃mergency department of a hospital for treatment of acute coronary syndrome from December 2018 to December 2022 as the study subjects.Ac⁃cording to whether cardiac arrest occurred 24 hours after admission,they were divided into case group(158 cases)and control group(142 ca⁃ses).The vital signs of patients in the case group were collected at 30 min,1 h,2 h,4 h,8 h,16 h and 24 h before cardiac arrest,and were brought into the modified early warning score scale and the importance early warning score scale.In the control group,the time points with complete data within 24 hours were randomly selected to correspond to the case group,and the contents and methods of collection were the same as those of the case group.Results At each time point 30 min to 24 h before cardiac arrest,the scores of the two scales in the case group were significantly higher than those in the control group(P<0.05).At 8 h before cardiac arrest,the area under the ROC curve of modi⁃fied early warning score scale was 0.642,which had a low predictive efficiency,and the area under the ROC curve of importance early warning score scale was 0.783,which had a medium predictive efficiency.Within 8 hours before cardiac arrest,the area under the ROC curve of the importance early warning score scale was>0.7,and there was no statistically significant difference between each value(P>0.05).And the im⁃portant early warning score scale had a good predictive effect on the occurrence of cardiac arrest in patients with various types of acute coro⁃nary syndrome.Conclusion The important early warning score has higher predictive effect than the modified early warning score,which can predict the occurrence of cardiac arrest 8 hours in advance,and has a good predictive effect on the occurrence of cardiac arrest in patients with various types of acute coronary syndrome.It is recommended for clinical application.
作者
李春萍
曾艳
蔡少青
杨露
刘元税
LI Chunping;ZENG Yan;CAI Shaoqing;YANG Lu;LIU Yuanshui(Department of Xiuying Emergency,Hainan General Hospital(Hainan Affifiliated Hospital of Hainan Medical University),Haikou 570311,China)
出处
《护理管理杂志》
CSCD
2024年第5期387-391,共5页
Journal of Nursing Administration
基金
海南省医药卫生科研项目(2001032061A2010)。
