Simplify The MEWS-4P Score And APACHE Ⅱ Score System In EICU Of Evaluation Value Of Critically Ill Patients

Objective: This topic is in order to simplify the MEWS-4 P score and the APACHE Ⅱ(acute physiology and chronic health evaluation II)score system for EICU(Emergency Intensive Care Unit)of evaluation value of critically ill patients for the purpose of comparison,By further perfecting the MEWS score,reduce temperature parameters,increase the PH value,PaO2,BNP,PCT,which simplify the MEWS-4p score,To increase its in EICU for critically ill patients prognosis judgement and assessment of the practicality,By comparing its and APACHE Ⅱ score system,and further determine the case fatality rate for patients,recovery rate and other prognostic accuracy.Methods: Collect EICU critically ill patients in 200 cases,respectively the simplified MEWS-4p score and APACHE Ⅱ score to evaluate patients,Analysis of the two methods of grading paragraphs score and the relationship between the case fatality rate,Comparing two evaluation methods for survival group and death group difference;Through the receiver-operating characterristic curve(receiver operator characteristic curve,the ROC),Comparing two scoring system to evaluate the prognosis of patients with accuracy;Analysis the correlation of two methods of grading and consistency.Results: Case fatality as the MEWS-4 P score and APACHE Ⅱ rating score higher and higher,the scores of death group was obviously higher than the survival group,the difference was statistically significant(P < 0.01).When the MEWS-4p score value of 9.2 points,sensitivity was 78.9%,73.2%,specific degrees Youden index most at this time;When APACHE Ⅱ score of20.8,the sensitivity was 80.24%,74.65%,Youden index most at this time.MEWS-4p score in the area under the ROC curve was 0.782(95%CI0.736-0.821),APACHE Ⅱ rating in the area under the ROC curve was0.818(95% CI0.759-0.882),there was no statistically significant differencecomparing the two scoring method.Two methods of grading of death group were greater than the ratings of survival,MEWS-4 P group was 12.23 ±1.56 score death survival group was 8.18 ± 2.77,t value is 6.912,the difference was statistically significant(P<0.01);APACHE Ⅱ score death group was23.92±3.76,survival group was 18.62±4.31,t value is 7.230,and the difference was statistically significant(P<0.01),The Spearman correlation analysis of testing,MEWS-4p score and APACHE Ⅱ scores were positively correlated(r = 0.882,P<0.001).Conclusion: MEWS-4p score and APACHE Ⅱ score can preliminary assessment EICU critically ill patient’s condition and prognosis,MEWS-4p score method to obtain data easily,low cost,quick and using method,diagnostic accuracy and with APACHE Ⅱ fairly,And APACHE Ⅱ score method to clinical data is more,it is relatively complex to use,so the assessment of the critically ill patients in EICU vigorously promote the use of MEWS-4p score.