3种创伤严重程度评分方法对老年创伤患者院内死亡预测价值的比较研究

doi:10.16460/j.issn1008-9969.2020.08.034

摘要/Abstract

摘要： 目的比较创伤重度程度评分、老年创伤结局评分以及损伤严重程度评分对老年创伤患者院内死亡风险的预测价值。方法回顾性分析2011年1月—2019年9月经急诊入院的523例老年创伤患者的临床资料,收集人口学信息、各种评分系统所涉及的项目信息、是否发生院内死亡。采用创伤重度程度评分、老年创伤结局评分以及损伤严重程度评分预测院内死亡的发生情况,通过计算受试者工作特征曲线下面积（AUC）,比较3种评分方法对老年创伤患者发生院内死亡的预测价值。结果在3个评分系统中,创伤重度程度评分的AUC最高（0.914）,其约登指数、特异度也最高分别为0.716、0.859,表现比较均衡;老年创伤结局评分的敏感度最高（0.971）,但特异度却最低（0.609）。结论创伤重度程度评分相较创伤结局评分、损伤严重程度评分在预测老年创伤患者院内死亡风险方面效能最好,评估更为全面,更适用于我国急诊早期入院的老年创伤患者的相关评估。

关键词: 老年, 创伤, 创伤评分, 预后, 死亡率

Abstract: Objective To compare the predictive value of Trauma Injury Severity Score (TRISS), Geriatric Trauma Outcome Score (GTOS) and Injury Severe Score (ISS) in the risk of death in hospital of elderly trauma patients. Methods The clinical data of 523 elderly trauma patients admitted to emergency department from January 2011 to September 2019 were analyzed retrospectively. Demographic information, project information involved in various scoring systems and in-hospital death information were collected. TRISS, GTOS and ISS were used to predict the occurrence of in-hospital deaths. By calculating the area under curve（AUC）, the predictive value of the three scoring systems for the occurrence of in-hospital deaths in elderly trauma patients was compared. Results Among the three scoring systems, the AUC of TRISS was the highest (0.914),with the highest Jordon index (0.716) and specificity (0.859), relatively balanced,. GTOS has the highest sensitivity (0.971), but the lowest specificity (0.609). Conclusion TRISS is the most effective in predicting the risk of death in hospital in elderly trauma patients for it is comprehensive and suitable for the evaluation of elderly trauma patients admitted to the emergency department in our country.

Key words: elderly, trauma, trauma score, prognosis, mortality rate

中图分类号:

R473.59

喻海涛, 孙琳, 韩小琴, 刘云. 3种创伤严重程度评分方法对老年创伤患者院内死亡预测价值的比较研究[J]. 护理学报, 2020, 27(8): 34-37.

YU Hai-tao, SUN Lin, HAN Xiao-qin, LIU Yun. Comparison of Three Trauma Severity Scoring Systems in Predicting In-hospital Death in Elderly Trauma Patients[J]. Journal of Nursing, 2020, 27(8): 34-37.

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