儿童早期预警评分在PICU病毒性脑炎患儿病情转归中的预测价值

摘要

Objective To explore the predictive value of Pediatric Early Warning Score (PEWS) in disease outcome for children with viral encephalitis in Pediatric Intensive Care Unit (PICU).Methods The clinical data of 49 children with viral encephalitis admitted in PICU of the First People's Hospital of Yunnan Province from November 2013 to September 2016 were analyzed retrospectively.Admission in the PICU was the observation starting point,transfer from the PICU or death was the endpoint.Results With the increase of PEWS score,the mortality rate of children with viral encephalitis increased correspondingly.There was significant difference in mortality rate among the low-risk group,middle-risk group and high-risk group (P＜0.05).The PEWS score in the nondeath group was significantly lower than the dealth-group (P＜0.01).Taking death as the prediction indicator,the area under the ROC curve of PEWS was 0.944 (95％CI 0.869-1.000,P＜0.01),the best cut-off point was 4,the Youden index was 0.844,the sensitivity was 100.0 ％,and the specificity was 84.4％.Conclusion PEWS has a high predictive value in disease outcome for children with viral encephalitis.%目的 研究儿童早期预警评分(PEWS)在儿科重症监护病房(PICU)病毒性脑炎患儿病情转归中的预测价值.方法 对入住PICU的49例病毒性脑炎患儿的临床资料进行回顾性分析.以入住PICU时为观察起点,转出PICU或病死为观察终点.结果 随着PEWS评分的增加,病毒性脑炎患儿的病死率相应升高,低危组与中危组、高危组的病死率比较,差异有统计学意义(P＜0.05);存活组PEWS评分较病死组低,差异有统计学意义(P＜0.01).以病死作为预测指标,PEWS的ROC曲线下面积为0.944(95％CI 0.869～1.000,P＜0.01),最佳截断点为4分,此时Youden指数最大为0.844,灵敏度为100.0％,特异度为84.4％.结论 PEWS对病毒性脑炎患儿病情转归有较高预测价值.