Clinic Study Of MEWS On Evaluating Emergency Medicine Patients’ Location And Prognosis

Objective:Evaluation modified early warning score the effectiveness of emergency medical to adult patients and prognosis, the study on the feasibility of MEWS score in clinical application, rapid assessment to the emergency department staff patients condition, reasonable distribution, monitoring patients to provide a scientific reference.Methods:Choose between January 2014 and March 2014 in Xinjiang during a third rate of hospital outpatient service medical treatment in adult patients as the research object, a prospective investigation. Record outpatient medical clinic, met inclusion exclusion standard object of study for the first time into the emergency room temperature, systolic blood pressure, heart rate, breathing rate and consciousness, and further to track the whereabouts of the patients with-whether in emergency medical Intensive care unit (Intensive care unit, ICU), when the prognosis of discharge status-whether death, to the hospital for 24 hours or more, with Acute physiology and chronic health evaluation patient records the APACHE Ⅱ score. According to patients’ to divided the patients into emergency medical ICU and non-emergency medical ICU group, according to the prognosis of patients with divided the patients into death group and alive group, according to the APACHE Ⅱ score could be divided into three levels patients. Using subjects area under operating characteristic curve (The area under The receiver operating characteristic cure, AUROCC) evaluation MEWS score evaluation ability, according to an index about MEWS grading evaluation criterion, through The screening evaluation indexes, The sensitivity, specific, positive predictive value, negative predictive value, coincidence rate, The decision results of MEWS score were analyzed. Results:1. The overall situation:this study investigated 1000, MEWS scoring average (3.24-2.05). With a total of 640 people with APACHE Ⅱ score, APACHE Ⅱ scoring average (14.29-6.51). 2. Different gender, different ethnic groups comparing differences between the MEWS rating of emergency medicine in adult patients have no statistical significance (P>0.05). 3. Compare the MEWS score and increase after age patients to AUROCC MEWS score evaluation, no statistically significant difference of two area under curve (P>0.05). MEWS after comparing MEWS score and increase the age factor score to predict the prognosis of patients with AUROCC, no statistically significant difference of two area under curve (P>0.05).4. Patients with severe disease group MEWS rating scores higher than that of critically ill patients, the MEWS rating of critically ill patients score higher than the light disease group, MEWS rating score difference between three groups with statistical significance (P<0.05).5. Scoring for MEWS and whereabouts, prognosis and patient, APACHE Ⅱ scores were positively correlated, the correlation coefficient of 0.300,0.640,0.580,0.634, respectively.6. Emergency medical ICU patients MEWS rating score higher than non-emergency medical ICU group, the differences between the two groups have statistical significance (P<0.05), and death patients MEWS rating score higher than the survival group, the differences between the two groups have statistical significance (P<0.05).7. MEWS grading evaluation of patients to AUROCC is 0.67, the sensitivity was 55.90%, specific degree is 71.80%, about an index of 0.28, the positive predictive value 54.90%, negative predictive value of 72.70%, the coincidence rate of 65.80%, MEWS score evaluation to four points, is the best cutoff value of MEWS seriously ill patients with a score of 4 points or more.8. MEWS score to predict the prognosis of patients with AUROCC is 0.96, the sensitivity was 95.50%, specific degree is 90.00%, about an index of 0.86, the positive predictive value 48.00%, negative predictive value of 99.50%, the coincidence rate of 90.50%, MEWS score to predict the prognosis of patients with the best cutoff value is 7 points, a patient’s risk of dying MEWS score of 7 or more.9. More MEWS score and APACHE Ⅱ score evaluation to AUROCC, no statistically significant difference (P>0.05). Comparing MEWS score and APACHE AUROCC Ⅱ predict the prognosis of patients, no statistically significant difference (P>0.05).10. Will be graded MEWS is classified into 0-3 points,4-6 and 7～14 points, three points. Section, the higher the score, the higher occupancy rate in patients with emergency medical ICU, emergency medical ICU occupancy rate comparison between three score differences statistically significant (P<0.05). Section, the higher the score, the higher the mortality in patients with the mortality of patients with comparison between three score differences statistically significant (P<0.05).Conclusion:1. The MEWS score can be used to evaluate the different gender, age, national emergency medicine in adult patients.2. MEWS score can be used to evaluate the prognosis of patients with emergency medical patients go, forecasting, MEWS score is higher, the patient, in the greater the risk that the emergency medical ICU, the worse prognosis.3. The MEWS score evaluation of emergency medical patients to the best cutoff value is four points, the best cutoff value is to predict the prognosis of patients with emergency medical 7 points.4. The MEWS score and APACHE Ⅱ score to have a moderate predictive value in patients with emergency medical, APACHE Ⅱ grading evaluation of the effect is a bit high. MEWS score for the prognosis of patients with emergency medicine has higher predictive value, APACHE Ⅱ score has moderate predictive value for the prognosis of patients with emergency medicine, MEWS score evaluation effectiveness is higher.