Objective To evaluate the application of modified early warning score ( MEWS ) system with pain score system in internal emergency department. Methods A MEWS with pain score was performed in 13 125 patients admitted to the internal emergency department of this hospital to evaluate the patients' acuity levels and analyze the outcome. Results A total of 2 405 patients were cured and left hospital ( 18. 32% ), 5 675 needed emergency observation ( 43. 24% ), 3 750 transferred to wards for treatment ( 28. 57% ), 1 221 to ICU ( 9. 30% ), 74 died in emergency rooms ( 0. 57% ). There was significant difference in mortality rate between patients at grades Ⅰ , Ⅱ , Ⅲ , Ⅳ, Ⅴ ( x2 = 11 853. 54, P = 0. 000 ); thereinto lower in patients at grades Ⅱ , Ⅲ, Ⅳ, than in those at grade Ⅰ , the difference was significant ( P < 0. 05 ); lower in patients at grades Ⅲ ,Ⅳ ,Ⅴ than in those at grade Ⅱ ( P < 0. 05 ); lower in patients at grades Ⅳ, Ⅴ than in those at grade Ⅲ ( P < 0. 05 ); lower in patients at grade Ⅴ than in those at grade Ⅳ ( P <0. 05 ). Conclusion MEWS with pain score system, which can reflex patients' condition better and evaluate patients' acuity levels rapidly, is worth applying in internal emergency department.%目的 探讨校正改良早期预警评分(MEWS)结合疼痛评分在急诊内科患者预后评估的应用价值.方法选取2012年5月1日-12月1日就诊于我院急诊内科的13 125例患者,进行校正MEWS及疼痛评分,评估患者危重级别,分析病情转归.结果 13 125例患者中,门诊治疗好转离院2 405例,占18.32%;急诊留观5 675例,占43.24%,专科病房住院3 750例,占28.57%;ICU住院1 221例,占9.30%;抢救室死亡74例,占0.57%.Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级、Ⅴ级患者病死率比较,差异均有统计学意义(χ2=11 853.54,P=0.000);其中Ⅱ级、Ⅲ级、Ⅳ级、Ⅴ级较Ⅰ级降低,Ⅲ级、Ⅳ级、Ⅴ级较Ⅱ级降低,Ⅳ级、Ⅴ级较Ⅲ级降低,Ⅴ级较Ⅳ级降低,差异有统计学意义(P＜0.05).结论 校正MEWS结合疼痛评分系统能更好地反应患者病情,能快速评估患者危重级别,值得在急诊内科推广应用.
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