Objective To study the value and feasibility of modified early warning score (MEWS) system in assessment of condition and prognosis of patients with acute cerebral infarction in pre-hospital environment. Methods Patients with confirmed diagnosis of acute cerebral infarction in pre-hospital first aid from January to July 2010 served as research object. Relevant on-site data were collected and evaluated using MEWS. The 90th day of admission to hospital was regarded as the observation terminal and the outcomes as the observation indicators. MEWS area under the receiver operator characteristic curve (AUROCC) of patients was calculated , and the relevant prognosis indicators of patients were analyzed. Results The MEWS scores of patients in death group were higher than those in survival group with statistically significant difference(P<0. 05). MEWS AUROCC was 0. 78, indicating greater than or equal to 3 points was the best cut-off point determining the severity degree of patients with acute cerebral infarction in pre-hospital environment. The sensitivity, specificity, accuracy and Youden s index of death prediction of critically ill patients were 45. 45% ,84. 61% ,81. 25% and 0. 30,respectively. Conclusion MEWS has a moderate ability to predict the condition and risk of death of patients with acute cerebral infarction.%目的 研究改良早期预警评分(MEWS)系统在院前急性脑梗死患者病情和预后评估的价值及可行性.方法 对2010年1～7月院前急救中明确诊断为急性脑梗死的患者作为研究对象,现场采集相关数据,进行MEWS评价,以收入院后第90 天为观察终点,结局作为观察指标,对患者进行MEWS受试者工作特征曲线下面积(AUROCC)计算,分析患者相应的预测指标.结果 死亡组MEWS评分较存活组高,差异有统计学意义(P<0.05);MEWS AUROCC为0.78,提示判断院前急救急性脑梗死患者危重程度的最佳截断点为大于或等于3分,对危重病患者死亡预测的敏感度、特异度、准确度及约登指数分别为45.45%、84.61%、81.25%及0.30.结论 MEWS对急性脑梗死患者病情及死亡风险具有中等的预测能力.
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