A simple 5-point scoring system, NaURSE (Na+, urea, respiratory rate and shock index in the elderly), predicts in-hospital mortality in oldest old.
A simple 5-point scoring system, NaURSE (Na+, urea, respiratory rate and shock index in the elderly), predicts in-hospital mortality in oldest old.
复制标题
DOI：
10.1093/ageing/afu002
复制
发表时间：
2014-05
期刊：
影响因子：
6.7
通讯作者：
A. H. Wilson;A. Kidd;J. Skinner;P. Musonda;Y. Pai;C. Lunt;C. Butchart;R. Soiza;J. Potter;P. Myint
中科院分区：
文献类型：
--
作者：
A. H. Wilson;A. Kidd;J. Skinner;P. Musonda;Y. Pai;C. Lunt;C. Butchart;R. Soiza;J. Potter;P. Myint
研究背景急性高龄患者病死率高。了解影响死亡率的预后因素将有助于临床医生做出适当的管理决策。方法我们分析了前瞻性死亡率审计数据(2008年11月至2009年1月)，以确定与高龄老年人住院死亡率相关的变量。我们选择了P145 mmoL/L、尿素(≥14 mmoL/L)、呼吸频率(>；20/分钟)和休克指数(>；1.0)的患者，得分为5分。0、1、2、3和4分的粗死亡率分别为9.5、19.9、34.4、66.7和100%。以≥2为界点，其特异度为87%(83.1~90.3)，灵敏度为39%(2 8.5~5 0.0)，AUC值为0.6 9(0.6 3~0.76)。一项外部独立验证研究(n=121)显示了类似的结果。结论NAURSE评分在确定住院期间可能死亡的高龄老年人方面可能特别有用，以指导适当的护理。
BACKGROUND the mortality is high in acutely ill oldest old patients. Understanding the prognostic factors which influence mortality will help clinicians make appropriate management decisions. METHODS we analysed prospective mortality audit data (November 2008 to January 2009) to identify variables associated with in-patient mortality in oldest old. We selected those with P 145 mmol/l), urea (≥14 mmol/l), respiratory rate (>20/min) and shock index (>1.0): creating a 5-point score (NaURSE: NaURS in the Elderly). The crude mortality rates were 9.5, 19.9, 34.4, 66.7, and 100% for scores 0, 1, 2, 3 and 4, respectively. Using the cut-off point of ≥2, the NaURSE score has a specificity of 87% (83.1-90.3) and sensitivity of 39% (28.5-50.0), with an AUC value of 0.69 (0.63-0.76). An external independent validation study (n = 121) showed similar results. CONCLUSIONS the NaURSE score may be particularly useful in identifying oldest old who are likely to die in that admission to guide appropriate care.