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在中高风险患者中预测急性肺栓塞的临床结果的国家早期预警得分
Audrey J C Overgaauw1, Esther J Nossent2,3, Lilian J Meijboom4,3
1Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
TH open : companion journal to thrombosis and haemostasis
|November 11, 2025
概括
国家早期预警分数 (NEWS) 可以帮助识别高风险急性肺栓塞 (PE) 患者,这些患者可能需要更密切的监测. 这一分数显示了改善PE患者风险分层的前景.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 肺部医学 肺部医学
背景情况:
- 欧洲心脏病学会 (ESC) 的指导方针可能导致急性肺栓塞 (PE) 的过度监测.
- 国家早期预警分数 (NEWS) 是一个广泛使用的分类工具,但在PE研究中未得到充分利用.
- 目前的PE风险分层可能无法准确识别需要密集监测的患者.
研究的目的:
- 评估NEWS与中高风险急性PE患者的不良结果之间的关联.
- 确定NEWS是否可以改善对患有血液动力学恶化或PE相关死亡风险的患者的识别.
- 评估NEWS在指导PE患者临床监测决策中的有用性.
主要方法:
- 成年PE患者的回顾性,单中心,观察性队列研究 (2017-2020).
- 新闻在入院时进行评估和24小时.
- 主要结局:血液动力学恶化或与PE相关的死亡;NEWS ≥5或最大单个参数得分表示高风险.
主要成果:
- 在318名PE患者中,99名患者的ESC风险中等至高;8%的患者达到主要结果.
- 提升的NEWS确定了52%的患者,其中13%的患者经历了不良结果.
- 非升高的NEWS对不良结果的预测值为98%的负值 (影响1名患者).
- 高度NEWS的敏感度为88%,中高风险患者的特异性为51%.
结论:
- NEWS可能会提高中高风险急性PE患者风险分层的准确性.
- 使用NEWS可以优化关于对PE患者的高级护理单位监测的决策.
- 新闻提供了一个潜在的工具来完善临床管理和资源分配在急性PE护理.
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