Rapid Emergency Medicine score: a new prognostic tool for in-hospital mortality in nonsurgical emergency department patients
Rapid Emergency Medicine score: a new prognostic tool for in-hospital mortality in nonsurgical emergency department patients
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DOI：
10.1111/j.1365-2796.2004.01321.x
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发表时间：
2004-05-01
影响因子：
11.1
通讯作者：
Lind, L
中科院分区：
文献类型：
--
作者：
Olsson, T;Terent, A;Lind, L
目标.评价快速急性生理学评分（RAPS）系统对急诊科（艾德）非手术患者住院死亡率和住院时间（LOS）的预测准确性，并探讨RAPS系统的扩展是否能提高其预测能力。前瞻性队列研究。一所拥有1200张床位的大学医院的成人艾德。在连续12个月内，共有12 006名非手术患者到艾德就诊。对于艾德的所有条目，计算RAPS（包括血压、呼吸率、脉率和格拉斯哥昏迷量表）。RAPS系统通过包括外周氧饱和度和患者年龄（快速急诊医学评分，REMS）进行扩展，并计算每例患者的新评分。分析两种评分系统与住院死亡率和住院LOS的统计学相关性。在预测住院死亡率方面，REMS优于RAPS（上级）[REMS的受试者工作特征（ROC）曲线下面积为0.852+/-0.014 SEM，RAPS为0.652+/-0.019 SEM，P
Objectives. To evaluate the predictive accuracy of the scoring system Rapid Acute Physiology score (RAPS) in nonsurgical patients attending the emergency department (ED) regarding in-hospital mortality and length of stay in hospital (LOS), and to investigate whether the predictive ability of RAPS could be improved by extending the system.Design. Prospective cohort study.Setting. An adult ED of a 1200-bed university hospital.Subjects. A total of 12 006 nonsurgical patients presenting to the ED during 12 consecutive months.Methods. For all entries to the ED, RAPS (including blood pressure, respiratory rate, pulse rate and Glasgow coma scale) was calculated. The RAPS system was extended by including the peripheral oxygen saturation and patient age (Rapid Emergency Medicine score, REMS) and this new score was calculated for each patient. The statistical associations between the two scoring systems and in-hospital mortality as well as LOS in hospital were examined.Results. The REMS was superior to RAPS in predicting in-hospital mortality [area under receiver operating characteristic (ROC) curve 0.852+/-0.014 SEM for REMS compared with 0.652+/-0.019 for RAPS, P