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国家早期预警评分-2用于识别患有中高风险肺栓塞的患者
Carmen Rodríguez1, Alfonso Muriel2, Luis Carrasco1
1Respiratory Department, Hospital Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
博瓦评分比国家早期预警评分2 (NEWS2) 更有效,用于识别患有稳定肺栓塞 (PE) 并发症高风险的患者. NEWS2通过额外的测试得到了改进,但没有超过Bova.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 临床风险分层的临床风险分层
背景情况:
- 共识指南建议在稳定的肺栓塞 (PE) 患者中进行风险分层的国家早期预警分数2 (NEWS2).
- 准确的风险评估对于识别PE诊断后中等至高风险的不良结果患者至关重要.
研究的目的:
- 为了外部验证NEWS2得分在预测稳定的PE患者30天复杂的过程中.
- 为了将NEWS2的预测性能与PE中不利结果的Bova得分进行比较.
- 评估NEWS2在与心声学和热血素测试相结合时,对风险分层的有用性.
主要方法:
- 在848名稳定的PE患者中,NEWS2 (切断值≥5和≥7) 和Bova得分 (切断值>4) 的外部验证.
- 测试特征的比较,用于预测30天复杂的过程.
- NEWS2的评估与心声回声和热素结果相结合.
主要成果:
- NEWS2 (≥5) 发现55.5%的患者有中高风险,而Bova发现4.4%.
- 与Bova (96.3%) 相比,NEWS2在30天复杂疗程中表现出明显较低的特异性 (45.4%) (p<0.001).
- 即使在较高的NEWS2值 (≥7),特异性 (88.9%) 仍然低于Bova. 将NEWS2 (≥7) 与热波和心声回声相结合,产生了97.8%的特异性.
结论:
- 在预测稳定PE患者中复杂的病程方面,Bova评分优于NEWS2.
- 虽然添加热素和心声回声学改善了NEWS2的特异性,但它没有超过Bova得分的表现.
- NEWS2可能需要改进或与其他标记物结合,以实现PE中最佳风险分层.
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