ABSTRACT
Objective To study the significance and feasibility of modified early warning scores (MEWS) assessing the conditions and death prediction among the pre-hospital acute poisoning patients.Methods We performed a prospective,observational study of the pre-hospital acute poisoning patients between January 1,2010 and December 31,2010.Data was collected to calculate the MEWS.Numeration data was presented in percentage by using chi-square test,and measurement data was expressed in mean with standard deviation,and P ＜ 0.05 was considered to be different with statistical significance.Observation lasted for 90 days after admission to get the results as observation index and ROC was drew and the area under the curve and the predicting index were calculated.The patients without vital signs and unsuccessful resuscitation were not included in this study.Results It showed 287 person times with 0 ～ 6 scores,accounting 94.4％,17 person times with 7-13 scores,accounting 5.59％,among the dead patients,MEWS were more than those of the survival group with statistical significance (P ＜ 0.05).The area under ROC was 0.99 indicating that MEWS≥7 was the board line for severe pre-hospital acute poisoning patients with sensitivity of 91.7％,specificity of 97.9％,accuracy of 97.7％ and Youden of 0.896 for predicting death.It showed high significance of the application of MEWS in assessing acute poisoning patients and death prediction.Conclusions MEWS assess pre-hospital acute poisoning patients and predict death with good resolution and strong application significance,which is simple,practical and applicable.
ABSTRACT
Objective To study the feasibility of modified early warning scores (MEWS) for assessing the severity and death prediction in the pre-hospital traumatic patients.MethodsData of the prehospital traumatic patients admitted between January 1,2010 and December 31,2010 were collected and assessed onsite by using MEWS.Numeration data was presented in percentage by using chi-square test,and measurement data was xepressed in mean with standard deviation,and P ＜ 0.05 was considered to be difference with statistical significance.Observation was lasted for 90 days after admission to get final results as observation object and ROC curve was drew and calculated the area under the curve for predicting severity and death of patients.The patients without vital signs and unsuccessful resuscitations were not included in this study.ResultsThere were 1475 (87.95％) cases/times with score of 0 -2,and 202 (12.05％)cases/times with score of 3 - 13.In the non-survival group,MEWS were higher than that in the survival group with statistic significance ( P ＜ 0.01 ).When the area under ROC was 0.94,the optimal cutoff point for potentially severe patients was MEWS≥3 for predicting the death of severe pre-hospital traumatic patients with sensitivity of 85.7％,specificity of 88.6％,accuracy of 88.6％ and Youden of 0.743,showing high significance of the application of MEWS to assessing severity of traumatic patients and death prediction.ConclusionsMEWS used to assess the pre-hospital traumatic patients and predict death with high validity and accurate quantification is a simple,practical and easily operable method with strong application significance.
ABSTRACT
Objective To explore risk factors in the mortality of casualties and to find a way to improve trauma emergency service. Method The possible factors likely related to the mortality of casualties were taken into account based on each stage of trauma emergency so as to find the independent risk factors by using univariate and multivariate analyses. Results A total of 3 659 casualties were enrolled in this study.Of them, 226 casualties died and the mortality rate was 6.18%. Following factors were related to mortality after univariate analysis: age, cause of trauma, injury severity score, Glasgow come scale come on the scene, professional emergency treatment on the scene, intubation in the ambulance, debridement and hemostasis in the ambulance, low blood pressure at admission, closed drainage of pleural cavity, emergency operation, CVP monitoring in ICU and mechanical ventilation in ICU. After multivariate analysis, six factors were independently related to the mortality of casualties as follows: Glasgow coma scale, injury severity score, mechanical ventilation, blood pressure at admission, age and professional emergency treatment on the scene. Conclusions It has a great significance to investigate the risk factors of mortality for casualties. Severity of trauma and age were independently associated with the outcomes of trauma. Besides, improving prehospital care and stabilizing the trauma patients in early phase can further decrease the mortality.
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Objective To study the pathogenesis, the diagnoses and the pre-hospital emergency treatment of comatose patients. Methods 314 comatose patients admitted to our hospital from September 2003 to September 2004 were analyzed retrospectively and followed in the hospital. Results Among 314 comatose patients, 119 had cerebrovascular accidents, 91 with poisoning, 42 with metabolic diseases, 37 cardiovascular diseases and 25 others. After pre-hospital treatment, 68 patients were recovered, 199 with stable conditions, 31 deterioated and 16 died. Conclusion Among the comatose patients, cerebral diseases and poisoning accounted for the most. The pre-hospital treatment could improve the successful rate of rescue.