Comparison of Glasgow Admission Prediction Score and Amb Score in predicting need for inpatient care
Comparison of Glasgow Admission Prediction Score and Amb Score in predicting need for inpatient care
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DOI：
10.1136/emermed-2017-207246
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发表时间：
2018-04-01
影响因子：
3.1
通讯作者：
Lowe, David J.
中科院分区：
文献类型：
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作者：
Cameron, Allan;Jones, Dominic;Lowe, David J.
目的比较格拉斯哥入院预测评分（GAPS）和门诊评分（Ambs）两种临床评分预测急诊科（艾德）处置的能力。我们招募了2016年2月至5月期间在两个英国研究中心（谢菲尔德的北方综合医院和格拉斯哥皇家医院）参加艾德分诊的连续患者。每个人都有一个GAPS和Ambs在分诊时计算，与分诊护士和治疗临床医生的分数不知情。患者随访至出院。在到达后12和48小时的评分区分出院艾德和从医院进行了比较，使用曲线下面积（AUC）的接收操作员特征（ROC）。GAPS预测入院的AUC显著更高，为0.807（95% CI 0.785至0.830），Ambs为0.743（95% CI 0.717至0.769），P <12小时和> 48小时。GAPS作为二元检验的准确性也更高，准确预测结果为1057例，而Ambs为1004例（74.2vs70.5%，P =0.012）。
Aim We compared the abilities of two established clinical scores to predict emergency department (ED) disposition: the Glasgow Admission Prediction Score (GAPS) and the Ambulatory Score (Ambs).Methods The scores were compared in a prospective, multicentre cohort study. We recruited consecutive patients attending ED triage at two UK sites: Northern General Hospital in Sheffield and Glasgow Royal Infirmary, between February and May 2016. Each had a GAPS and Ambs calculated at the time of triage, with the triage nurses and treating clinicians blinded to the scores. Patients were followed up to hospital discharge. The ability of the scores to discriminate discharge from ED and from hospital at 12 and 48 hours after arrival was compared using the area under the curve (AUC) of their receiving-operator characteristics (ROC).Results 1424 triage attendances were suitable for analysis during the study period, of which 567 (39.8%) were admitted. The AUC for predicting admission was significantly higher for GAPS at 0.807 (95% CI 0.785 to 0.830), compared with 0.743 (95% CI 0.717 to 0.769) for Ambs, P 12 hour and > 48 hour. GAPS was also more accurate as a binary test, correctly predicting 1057 outcomes compared with 1004 for Ambs (74.2vs70.5%, P=0.012).Conclusion The GAPS is a significantly better predictor of need for hospital admission than Ambs in an unselected ED population.