摘要
目的比较MEWS评分、血糖值评分及两评分结合预测糖尿病急性并发症患者预后的能力,以探索出最适合的评估工具。方法选取住院的糖尿病急性并发症患者419例为研究对象,从患者入院时作为观察起点,分别进行MEWS评分、血糖值评分、MEWS结合血糖值评分,以出院时的预后为观察指标,通过ROC曲线比较三种评分预测患者预后的准确度。结果以死亡为预测指标时,MEWS评分受试者操作特征曲线下面积AUC_(ROC)=0.875,最佳截断值为>4分,敏感度为78.43%,特异度为85.60%,阳性预测值为43.01%,阴性预测值为96.63%;血糖值评分受试者操作特征曲线下面积AUC_(ROC)=0.681,最佳截断值为2分,敏感度为50.98%,特异度为85.33%,阳性预测值为73.4%,阴性预测值为67.5%;两评分结合受试者操作特征曲线下面积AUC_(ROC)=0.982,最佳截断值为>7分,敏感度为94.12%,特异度为95.65%,阳性预测值为75%,阴性预测值为99.15%。结论两评分结合预测糖尿病急性并发症患者预后的分辨度高于单纯MEWS评分与血糖值评分,值得临床推广应用。
Objective To compare the Modified Early Warning Score （MEWS） , blood glucose value score and the two scores combined with the ability to predict the prognosis of patients with acute complication of diabetes mellitus, and to explore the most suitable assessment tools. Methods 419 patients with acute complications were collected in diabetic mellitus. To put the admission time as the inital observation point, MEWS score, blood glucose value score and MEWS combined with blood glucose value were assessed and compared between the time point of admission and discharge by ROC curve. Results Using death as a prediction index, MEWS score of subjects operating characteristic area under the curve of AUCROC was 0.875 and the optimal cut-off value of was over 4 in the sensitivity of 78.43%, specificity of 85.60%, the positive predictive valueof 43.01% and the negative predictive value of 96.63% independently. The average score of blood glucose area under ROC curve AUCROC was 0.681 and the optimal cut-off value was 2 in the sensitivity of 50.98%, the specificity of 85.33% the positive predictive value of 73.4% and negative predictive value of 67.5% respectively. Two scores combined with area under ROC curve AUCROCwas 0.982, and the optimal cut-off value was over 7 in the sensitivity of 94.12%, the specificity of 95.65%, the positive predictive value of 75% and the negative predictive value of 99.15% individually. Conclusion For predicting the prognosis of patients with acute complications of diabetes, the combined scores are better than the pure MEWS score and blood glucose value. It is worth of clinical application.
出处
《实用医学杂志》
CAS
北大核心
2018年第3期397-400,共4页
The Journal of Practical Medicine
基金
河南省医学科技攻关计划项目(编号:201602363)
关键词
改良早期预警评分
血糖值
糖尿病
预后
modified early warning score
blood glucose
diabetes mellitus
prognosis
