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目的对新生儿危重病例评分(NCIS)和第三代小儿死亡危险(PRISMⅢ)评分评估新生儿死亡风险的预测价值进行分析,探讨PRISMⅢ评分在我国推广的可行性。方法前瞻性纳入2014年7月至2015年6月在我院新生儿重症监护室住院的所有新生儿,分别采用PRISMⅢ和NCIS评分评价新生儿疾病的危重程度。以新生儿是否死亡为结局,绘制两种方法的工作特征曲线,比较两曲线下面积(AUC)的差异。结果共纳入297例患儿,38例死亡。NCIS评分判断新生儿危重程度的AUC为0.923,PRISMⅢ评分为0.919,两种方法均较准确,且差异无统计学意义(P>0.05)。结论 PRISMⅢ评分在预测危重新生儿死亡风险方面与我国常用的NCIS评分准确性相近,为新生儿死亡风险评估提供了另一种选择,临床上可分别采用两种方法进行评估以达到相互佐证的目的。
Objective To analyze the predictive value of NCIS and PRISMⅢ in assessing the risk of neonatal death, and to explore the feasibility of PRISMⅢscale in China. Methods All newborns hospitalized in our neonatal intensive care unit from July 2014 to June 2015 were prospectively included in this study. The severity of neonatal disease was evaluated using the PRISM III and NCIS scores respectively. Taking neonatal deaths as the outcome, the working characteristic curves of the two methods were plotted and the differences between the areas under the two curves (AUC) were compared. Results A total of 297 children were included and 38 died. NCIS score to determine the severity of neonatal AUC was 0.923, PRISMⅢ score of 0.919, the two methods are more accurate, and the difference was not statistically significant (P> 0.05). Conclusion The PRISMⅢ score is similar to the accuracy of NCIS commonly used in our country in predicting the risk of death in critically ill newborns. It provides another alternative for the risk assessment of neonatal death. Two methods can be used clinically to achieve mutual supportive goals .