...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Prehospital emergency care >Assessing Severity of Illness in Patients Transported to Hospital by Paramedics: External Validation of 3 Prognostic Scores
【24h】

Assessing Severity of Illness in Patients Transported to Hospital by Paramedics: External Validation of 3 Prognostic Scores

机译：评估由护理人员运送到医院的患者疾病的严重程度：3预后分数的外部验证

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Introduction: Emergency Medical Services (EMS) are the first healthcare contact for the majority of severely ill patients. Physiologic measures collected by EMS, when incorporated into a prognostic score, may provide important information on patient illness severity. This study compares the predictive ability of 3 common prognostic scores for predicting clinical outcomes in EMS patients. Methods: Discrimination and calibration for predicting the primary outcome of hospital mortality, and secondary outcomes of 2-day mortality and ED disposition, were assessed for each of the scores using a one-year cohort of patients transported to hospital by EMS in Alberta, Canada. For each score, binary logistic regression was used to predict hospital mortality and 2-day mortality and ordinal logistic regression was used to predict ED disposition. Discrimination for each outcome was assessed using C-statistics, and calibration was assessed using calibration curves comparing predicted versus observed outcomes. Results: The Critical Illness Prediction [CIP], Modified Early Warning Score [MEWS], and National Early Warning Score [NEWS] were compared using 121,837 adult patients who were transported by paramedics. All scores had good discrimination for hospital mortality (C-statistic CIP: 0.79, MEWS: 0.71, NEWS: 0.78) and 2-day mortality (CIP:0.85, MEWS: 0.80, NEWS:0.85) but only moderate discrimination for ED disposition (CIP: 0.68, MEWS: 0.61, NEWS: 0.66). Calibration was reliable for hospital mortality in all scores but over-predicted risk for 2-day mortality at higher scores. Overall, the CIP score had the best discrimination, good calibration, and the greatest range of predicted probabilities (0.01 at a CIP score of 0 to 0.92 at a CIP score of 8) for hospital mortality. Conclusions: Prognostic scores using physiologic measures assessed by paramedics have good predictive ability for hospital mortality. These scores, particularly the CIP score, may be considered as a tool for mortality risk stratification or as a general measure of illness severity for patients included in EMS studies. Key words: prognostic; illness severity; prehospital
机译：简介：紧急医疗服务（EMS）是大多数严重病患者的医疗保健联系。 EMS收集的生理措施，当纳入预后评分时，可以提供有关患者疾病严重程度的重要信息。该研究比较了3种常见预后评分的预测能力，以预测EMS患者的临床结果。方法：对预测医院死亡率的主要结果的歧视和校准，以及2天死亡率和ED处理的二次结果，用于使用在加拿大艾伯塔省的EMS向医院运送到医院的一年患者的每一个分数进行评估。对于每种分数，二进制物流回归用于预测医院死亡率，2天死亡率和序数逻辑回归用于预测ED处理。使用C统计评估每个结果的歧视，使用校准曲线进行评估校准，比较预测与观察结果相比。结果：临界疾病预测[CIP]，修改了预警分数[MEWS]和国家预警分数[新闻]使用由护理人员运输的121,837名成年患者进行比较。所有分数都有良好的医院死亡率歧视（C统计CIP：0.79，MEWS：0.71，新闻：0.78）和2天死亡率（CIP：0.85，MEWS：0.80，新闻：0.85），但仅适度歧视ED倾向（ CIP：0.68，MEWS：0.61，新闻：0.66）。校准对于所有分数的医院死亡率是可靠的，但在较高分数下的2天死亡率的过度预测风险。总体而言，CIP评分具有最佳的歧视，良好的校准以及最大的预测概率（0.01，CIP得分为0至0.92的CIP得分为8），用于医院死亡率。结论：医疗主体评估的生理措施的预后评分具有良好的医院死亡能力。这些评分，特别是CIP评分，可以被认为是死亡风险分层的工具，或作为EMS研究中包括的患者的疾病严重程度的一般性。关键词：预后;疾病严重程度;先前

著录项

  • 来源
    《Prehospital emergency care》 |2020年第2期|共9页
  • 作者

    Lane Daniel J.; Wunsch Hannah; Saskin Refik; Cheskes Sheldon; Lin Steve; Morrison Laurie J.; Scales Damon C.;

  • 作者单位

    Univ Toronto Dalla Lana Sch Publ Hlth Inst Hlth Policy Management &

    Evaluat Toronto ON Canada;

    Univ Toronto Dalla Lana Sch Publ Hlth Inst Hlth Policy Management &

    Evaluat Toronto ON Canada;

    Univ Toronto Dalla Lana Sch Publ Hlth Inst Hlth Policy Management &

    Evaluat Toronto ON Canada;

    St Michaels Hosp Li Ka Shing Knowledge Inst Toronto ON Canada;

    Univ Toronto Dalla Lana Sch Publ Hlth Inst Hlth Policy Management &

    Evaluat Toronto ON Canada;

    Univ Toronto Dalla Lana Sch Publ Hlth Inst Hlth Policy Management &

    Evaluat Toronto ON Canada;

    Univ Toronto Dalla Lana Sch Publ Hlth Inst Hlth Policy Management &

    Evaluat Toronto ON Canada;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 护理学;
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号