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この研究成果の引用には次のURIを利用してください。: http://hdl.handle.net/10285/13545

種類: Thesis or Dissertation
タイトル: The Comparison of National Early Warning Score and Visensia Score Index as an Activation Trigger for Rapid response systems in an outpatient setting.
タイトル別表記: 内科初診外来における National Early Warning Score と Visensia score index の臨床予測精度の比較検討
著者: 江原, 淳
著者名ヨミ: エハラ, ジュン
指導教官: 大出, 幸子
キーワード: rapid response team
severity of illness index
early warning score
clinical deterioration
intensive care units
調査法・尺度: sensitivity and specificity
ROC curve
predictive value of tests
発行年月日: 2020年3月
抄録: There have been solid triage systems to detect a critical-ill patient in-hospital setting using early warning systems. In an outpatient setting, there is no systematic ways to triage patients with serious condition. We conducted pilot study last year aimed to determine the performance of national NEWS among patients who activated RRS in an outpatient setting. In the result, the difference between the NEWS at the time of deterioration and at disposition might usefully predict admissions and poor clinical outcomes. This single-center retrospective cohort study aimed to to investigate and compare efficacy of NEWS and VSI as a prediction tool and as an activation trigger for rapid response systems among whole first-visit patients of our internal medicine clinic. From June 1, 2018 to November 30, 2018 at a 350-bed teaching community hospital in Japan. Patient age and sex, and physiological measurements, NEWS, VSI as well as disposition and outcomes were collected. 3301 patients were included. One-hundred eight (3.3%), and 16 (0.5%), and 5 (0.2%) of the patients were admitted to a general ward, HCU, or ICU, respectively. The area under the curve (AUC) of NEWS for admission, HCU or ICU admission, and ICU admission were 0.71 (95% Confidence interval : CI, 0.66 - 0.76); 0.88 (95% CI, 0.80 - 0.97); and 0.998 (95% CI, 0.996-1.0), respectively. AUC of VSI for admission, HCU or ICU admission, and ICU admission were 0.66 (95%CI, 0.60 - 0.71); 0.82 (95% CI, 0.71 - 0.93); and 0.97 (95% CI, 0.96-0.98), respectively. AUC of NEWS was significantly superior than AUC of VSI for admission and for ICU admission (p = 0.03, p<0.01).
本文の種類: none
リンクURL: http://hdl.handle.net/10285/13545
出現コレクション:実践課題 - Capstone Project


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