创伤指数对住院和重症监护室入院的预测能力
Lillian Caroline Fernandes1, Daniel Bueno Damasceno2, Fernanda Naves de Oliveira Lima2
1Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil.
Revista da Escola de Enfermagem da U S P
|September 8, 2025
概括
伤害严重性评分 (ISS) 和新伤害严重性评分 (NISS) 有效预测创伤患者的住院和ICU入院情况. 其他指数,REMS和mREMS,显示这些预测的表现不足.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 临床结果研究研究
背景情况:
- 创伤严重程度指数对于预测患者结果至关重要.
- 像ISS和NISS这样的现有指数被广泛使用,但它们的比较表现需要持续评估.
- 像REMS和mREMS这样的新兴指数需要根据既有措施进行验证.
研究的目的:
- 评估和比较四个创伤严重程度指数的预测性表现:伤害严重程度得分 (ISS),新伤害严重程度得分 (NISS),修订创伤得分 (RTS) 和修改修订创伤得分 (mREMS).
- 确定这些指数在预测创伤后入院和重症监护室 (ICU) 入院方面的有效性.
主要方法:
- 进行了一项回顾性队列研究,涉及151名在24小时内入院的成人创伤患者.
- 数据是从2020年1月到2022年1月在一家私立医院的急诊室收集的.
- 在预测医院和ICU入院方面,ISS,NISS,REMS和mREMS的性能使用接收器操作特征曲线 (AUC/ROC) 下面的区域进行了分析.
主要成果:
- 伤害严重性评分 (ISS) 和新伤害严重性评分 (NISS) 显示出强大的医院和ICU入院预测能力,AUC/ROC值在0.84到0.85.85之间.
- 修改后的创伤评分 (REMS) 和修改后的创伤评分 (mREMS) 的表现不够,AUC/ROC值在0.62和0.67.6之间.
- 在两组指数之间观察到预测准确度的显著差异.
结论:
- 国际空间站和NISS被认可为预测创伤患者入院和ICU入院的有效工具,并被推用于临床使用.
- 雷姆斯和mREMS指数在预测这些特定结果方面表现不够好,因此不建议在这种情况下对其进行临床应用.
- 进一步的研究可能会探索REMS和mREMS的修改或替代应用,但目前的证据表明,预测入学结果的实用性有限.
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