Journal of Hayat
حیات
Hayat
Medical Sciences
http://hayat.tums.ac.ir
1
admin
1735-2215
2008-188X
fa
jalali
1405
1
1
gregorian
2026
4
1
32
1
online
1
fulltext
fa
ارزیابی دقت تشخیصی نمرات هشداردهنده زودرس در پایش تروما از مراقبت پیش بیمارستانی تا بخش مراقبت های ویژه
Diagnostic accuracy of early warning scores in trauma monitoring from pre-hospital care to the intensive care unit
مراقبتهاي پرستاري
Nursing Care
پژوهشي
Research
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">زمینه و هدف: </span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">تعیین مقدار خطری که بیماران را تهدید می­کند می­تواند به اتخاذ تصمیمهای درمانی صحیح منجر شود.­ مطالعه حاضر با هدف تعیین دقت تشخیصی نمرات هشداردهنده اولیه در مراقبت پیش بیمارستانی جهت تشخیص آسیب تروماتیک مغزی و نیاز به بستری در بخش مراقبتهای ویژه انجام گرفته است</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black">.</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">روش بررسی:</span></span></span></span></i></b><i> </i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">این مطالعه توصیفی- تحلیلی در سال 1403 در مورد بیماران مراجعهکننده به اورژانس بیمارستان­های منتخب وابسته به دانشگاه علوم پزشکی تهران انجام یافت. با استفاده از نمونه­گیری در دسترس 250 بیمار دچار تروما وارد مطالعه شدند. جهت جمع­آوری اطلاعات از پرسشنامه اطلاعات جمعیتشناختی و نمرات امتیاز هشدار اولیه ملی 2 (</span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NEWS2</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">)، امتیاز هشدار اولیه اصلاح شده (</span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">MEWS</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">)، امتیاز هشدار اولیه تریاژ (</span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">TEWS</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">) و امتیاز پزشکی اورژانس اصلاح شده </span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">MREMS)</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">) استفاده شد. جهت تحلیل داده­ها از نرمافزار </span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">SPSS</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""> نسخه 16 و آزمونهای حساسیت، ویژگی، سطح زیر منحنی راک و فاصله اطمینان استفاده شد<span style="color:black"><span style="letter-spacing:-.2pt">.</span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="tab-stops:163.05pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:.1pt">یافتهها</span></span></span></span></i></b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:.1pt">: </span></span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">میانگین و انحراف معیار سن بیماران 78/15</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span cambria="" style="font-family:">±</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">90/40 سال بود. طبق یافته­ها 217 نفر (8/86%) از بیماران تشخیص آسیب تروماتیک مغزی و 70 نفر (28%) تشخیص نیاز به بستری در بخش مراقبتهای ویژه داشتند. امتیاز هشدار اولیه ملی 2 بالاترین دقت تشخیصی را با حساسیت 2/82% و ویژگی 1/81% و سطح زیر منحنی راک 88/0 نشان داد<span style="color:black"><span style="letter-spacing:.1pt">.</span></span></span></span></i></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">نتیجهگیری: </span></span></span></span></i></b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">دقت تشخیصی بالاتر امتیاز هشدار اولیه ملی 2، آن را به یک ابزار ارزشمند در شناسایی بیمارانی که دچار آسیب تروماتیک مغزی شدهاند و نیاز به بستری در بخش مراقبتهای ویژه دارند، تبدیل میکند<span style="color:black">.</span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Background & Aim:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">Determining the amount of risk that threatens patients can lead to making correct treatment decisions. This study aimed to determine the diagnostic accuracy of early warning scores in prehospital care for diagnosing traumatic brain injury and the need for intensive care unit admission</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Methods & Materials:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">This descriptive-analytical study was conducted in 2024 among patients referred to the emergency department of selected hospitals affiliated with Tehran University of Medical Sciences. Using convenience sampling, 250 trauma patients were enrolled in the study. Data collection was carried out utilizing a demographic questionnaire and various scoring systems, including the National Early Warning Score 2 (NEWS2), Modified Early Warning Score (MEWS), Triage Early Warning Score (TEWS), and Modified Emergency Medical Score (MREMS). SPSS version 16 software and sensitivity, specificity, area under the curve, and confidence interval tests were used to analyze the data</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt"><span style="layout-grid-mode:line">Results:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">The mean age of the patients was 40.90±15.78 years. According to the findings, 217 patients (86.8%) had a diagnosis of traumatic brain injury and 70 patients (28%) required intensive care unit admission. The National Early Warning Score 2 showed the highest diagnostic accuracy with sensitivity (82.2%), specificity (81.1%), and area under the curve (0.88)</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"><span style="layout-grid-mode:line">Conclusion:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">The higher diagnostic accuracy of the National Early Warning Score 2 makes it a valuable tool for identifying patients who have sustained traumatic brain injury and require intensive care unit admission</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">.</span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></b></span></span></span></span></span><br>
نمرات هشداردهنده زودرس, پرستاری تروما, بخش مراقبتهای ویژه, آسیب تروماتیک مغزی
early warning scores, trauma nursing, intensive care unit, traumatic brain injury
27
40
http://hayat.tums.ac.ir/browse.php?a_code=A-10-869-9&slc_lang=fa&sid=1
Mohammad
Ganji
محمد
گنجی