| Citation: |
YU Min, CAO Yun, QIU Jiawen, ZHOU Juan, HE Bin, HAO Weiwen. Value of two score systems for unplanned transfer of patients from emergency observation room to emergency room[J]. Journal of Clinical Medicine in Practice, 2022, 26(22): 48-51. DOI: 10.7619/jcmp.20222757
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To compare the predictive effect of the Modified Early Warning Score (MEWS) and the National Early Warning Score (NEWS) on the unplanned transfer of patients from emergency observation room to emergency room.
A retrospective analysis was performed for 333 patients in the emergency observation room, including 47 cases who were unplanned transferred to the emergency room. Among 47 patients transferred to the emergency room, 37 patients with NEWS≥3 were included in abnormal NEWS group, and 24 patients with MEWS≥2 were included in abnormal MEWS group. General data, MEWS, NEWS and deterioration condition of vital organs during transfer to the emergency room were recorded. After 72 h of observation, receiver operating characteristic (ROC) curve was drawn according to the outcome of patients, and the predictive value of the two scoring systems for unplanned transfer from emergency observation room to emergency room was compared, and the difference of the predictive value of the two scoring systems for the deterioration of vital organs was further analyzed.
There were statistically significant differences in age, albumin level, MEWS and NEWS between two groups (P < 0.05). ROC curve results showed that the area under the curve (AUC) of NEWS was 0.86, the optimum cut-off value scored 3, the sensitivity was 0.83, and the specificity was 0.77. AUC of MEWS was 0.78, the optimum cut-off value scored 2, the sensitivity was 0.77, and the specificity was 0.75. AUC of two scoring systems in predicting unplanned transfer to the emergency room was compared, and the difference was statistically significant (Z=2.03, P=0.04). There was statistical significance in the proportion of respiratory failure patients between the two groups (P < 0.05).
Compared with MEWS, NEWS has a higher value in predicting unplanned transfer from emergency observation room to emergency room, and its advantage may be based on the prediction of respiratory failure.
| [1] |
朱莹, 蒋婕, 陶然君, 等. 急诊科患者滞留现象的研究及对策[J]. 中华急诊医学杂志, 2013, 22(12): 1435-1438. doi: 10.3760/cma.j.issn.1671-0282.2013.12.034
|
| [2] |
SUBBE C P, KRUGER M, RUTHERFORD P, et al. Validation of a modified Early Warning Score in medical admissions[J]. QJM, 2001, 94(10): 521-526. doi: 10.1093/qjmed/94.10.521
|
| [3] |
MENON U, KALSI J, JACOBS I, et al. International Conference on Ovarian Cancer Screening[J]. International Journal of Gynecological Cancer, 2012, 22: S1. doi: 10.1097/IGC.0b013e3182557e41
|
| [4] |
HWANG J I, CHIN H J. Relationships between the National Early Warning Score 2, clinical worry and patient outcome at discharge: retrospective observational study[J]. J Clin Nurs, 2020, 29(19/20): 3774-3789.
|
| [5] |
GREEN M, LANDER H, SNYDER A, et al. Comparison of the Between the Flags calling criteria to the MEWS, NEWS and the electronic Cardiac Arrest Risk Triage (eCART) score for the identification of deteriorating ward patients[J]. Resuscitation, 2018, 123: 86-91. doi: 10.1016/j.resuscitation.2017.10.028
|
| [6] |
GOULDEN R, HOYLE M C, MONIS J, et al. qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as Sepsis[J]. Emerg Med J, 2018, 35(6): 345-349. doi: 10.1136/emermed-2017-207120
|
| [7] |
BRINK A, ALSMA J, VERDONSCHOT R J C G, et al. Predicting mortality in patients with suspected Sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score[J]. PLoS One, 2019, 14(1): e0211133. doi: 10.1371/journal.pone.0211133
|
| [8] |
BRANGAN E, BANKS J, BRANT H, et al. Using the National Early Warning Score (NEWS) outside acute hospital settings: a qualitative study of staff experiences in the West of England[J]. BMJ Open, 2018, 8(10): e022528. doi: 10.1136/bmjopen-2018-022528
|
| [9] |
DEWAR Z E, KIRCHNER H L, RITTENBERGER J C. Risk factors for unplanned ICU admission after emergency department holding orders[J]. J Am Coll Emerg Physicians Open, 2020, 1(6): 1623-1629. doi: 10.1002/emp2.12203
|
| [10] |
KUO S C H, KUO P J, CHEN Y C, et al. Comparison of the new Exponential Injury Severity Score with the Injury Severity Score and the New Injury Severity Score in trauma patients: a cross-sectional study[J]. PLoS One, 2017, 12(11): e0187871. doi: 10.1371/journal.pone.0187871
|
| [11] |
梁虹艺, 黄雪峰, 莫泽珣, 等. 食管癌患者术后发生低蛋白血症的影响因素及其对临床结局的影响[J]. 广东药科大学学报, 2021, 37(3): 117-122. https://www.cnki.com.cn/Article/CJFDTOTAL-GDYX202103027.htm
|
| [12] |
操斌全, 汪芸, 胡星星, 等. 静脉应用白蛋白对慢性失代偿性心力衰竭合并低蛋白血症患者再住院及预后的影响[J]. 中国实用医药, 2021, 16(18): 12-15. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA202118003.htm
|
| [13] |
王春源, 曹涛, 勤俭, 等. 英国国家早期预警评分对急诊老年严重脓毒症及脓毒症休克患者预后的评估价值[J]. 实用临床医药杂志, 2017, 21(15): 1-4. doi: 10.7619/jcmp.201715001
|
| [14] |
刘芳艳, 李春盛, 何庆, 等. 英国国家早期预警评分对我国急诊老年患者死亡预测的多中心研究[J]. 中国急救医学, 2015, 35(4): 313-316. doi: 10.3969/j.issn.1002-1949.2015.04.006
|
| [15] |
SMITH G B, PRYTHERCH D R, MEREDITH P, et al. The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death[J]. Resuscitation, 2013, 84(4): 465-470. doi: 10.1016/j.resuscitation.2012.12.016
|
| [16] |
SMITH G B, REDFERN O C, PIMENTEL M A, et al. The national early warning score 2 (NEWS2)[J]. Clin Med: Lond, 2019, 19(3): 260. doi: 10.7861/clinmedicine.19-3-260
|
| [17] |
林玲, 顾秀萍. 儿童早期预警评分结合指脉氧评分在呼吸科病情评估中的应用[J]. 中国现代医药杂志, 2020, 22(10): 80-82. doi: 10.3969/j.issn.1672-9463.2020.10.025
|
| [18] |
张佳佳, 梁世景, 罗诗婷. ICU病人院内转运检查的风险与影响因素[J]. 护理研究, 2019, 33(24): 4343-4346. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201924036.htm
|
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