基于GRACE评分的非ST段抬高型急性冠脉综合征患者分诊量表的构建与应用

陈天喜; 翁卫群; 崔秋霞; 沈红五; 单君; 孙宏; 周雪梅

doi:10.13201/j.issn.1001-1439.2019.08.010

基于GRACE评分的非ST段抬高型急性冠脉综合征患者分诊量表的构建与应用

- 1 南通大学附属医院急诊科(江苏南通, 226001);
- 2南通大学护理学院;
- 3 南通市第一人民医院门诊部
基金项目:
南通市市级科技计划资助项目 (No:MS12017009-1)

详细信息

通讯作者: 翁卫群, E-mail:wengweiqun011@163.com

中图分类号: R541.4

收稿日期: 2018-11-23

Establishment and application of triage scale for triage scale for Non-ST-segment elevation acute coronary syndrome patients based on grace

- 1 Department of Emergency, Affiliated Hospital of Nantong University, Nantong, 226001, China;
- 2 School of Nursing, Nantong Universitv;
- 3 Out Patient Department of Nantong First People's Hospital

More Information

Corresponding author: WENG Weiqun, E-mail: wengweiqun011@163.com

Received Date: 23 November 2018

摘要

摘要: 目的:构建适合急诊非ST段抬高型急性冠状动脉综合征 (NSTE-ACS) 的预检分诊量表 (TSNSTEACS) , 并验证应用效果。方法:采用方便抽样法抽取2016-04-2017-04的454例NSTE-ACS患者, 基于GRACE评分系统, 结合一般评估资料作为自变量, 以NSTE-ACS患者的急诊分诊级别为因变量, 构建Logistic回归模型。根据自变量的权重, 对有统计学意义的自变量条目进行条目赋值形成TS-NSTEACS, 通过ROC曲线确定TS-NSTEACS的各分诊级别的界值, 并进行信效度评价;选择2017-07-2018-07期间450例NSTE-ACS胸痛患者作为试验组, 将TS-NSTEACS运用于试验组, 以2016-04-2017-04期间454例NSTE-ACS为对照组, 比较两组的分诊不足、分诊过度和分诊耗时。结果:构建的TS-NSTEACS包括14个条目, 评分≥7分为Ⅰ级危急;5≤评分≤6为Ⅱ级危重;4分为Ⅲ级急症;评分≤3为Ⅳ非急症。总量表的Cronbach'sα系数为0.710, 探索性因子分析提取4个公因子, 其方差累积贡献率为63.979%;试验组应用TS-NSTEACS后, 分诊不足和分诊过度发生率分别是4.22%和3.33%, 低于对照组的9.25%和10.57% (P<0.05) ;而分诊耗时 (7.33±1.78) min较对照组 (8.06±2.39) min缩短 (P<0.05) 。结论:本研究基于GRACE评分构建的TS-NSTEACS有良好的信效度和临床分诊效果, 值得推广使用。
- GRACE评分 /
- 非ST段抬高型急性冠状动脉综合征 /
- 预检分诊 /
- 量表
Abstract: Objective:To establish a triage scale for Non-ST-segment elevation acute coronary syndrome patients, and test its clinical effect.Method:A total of 454 NSTE-ACS patients were selected between 2016-04 and2017-04 using convenience sampling.Based on Grace scoring, an ordered Logistic regression model was established with general assessment data as independent variables and emergency triage level of NSTE-ACS patients as a dependent variable.According to the weights of independent variables, re-assigning was carried out for statistically significant independent variables to establish the TS-NSTEACS.Boundary values of TS-NSTEACS levels were determined using the ROC curve, and reliability and validity were evaluated.The 450 suspected NSTEACS patients with pectoralgia between 2017-07 and 2018-07 were included in experiment group in which the TS-NSTEACS was applied, and 454 NSTE-ACS patients between 2016-04 and 2017-04 were in control group.The incidence rate of insufficient and excessive triage, the duration of triage were compared between the 2 groups.Result:The established TS-NSTEACS included 14 items, with score≥7 as level I emergency, 5≤score≤6 as level II emergency, score=4 as level III emergency, and score≤3 as level IV non-emergency.Cronbach'sαcoefficient of the scale was 0.710.Four common factors were extracted in exploratory factor analysis, with a cumulative contribution rate of variance of 63.979%.After applying the TS-NSTEACS, The incidence rate of insufficient and excessive triage were 4.22%and 3.33%respectively which was lower than 9.25%and 10.57%of the control group (P<0.05) , and the duration of triage (7.33±1.78) was shortened compared with the control group (8.06 ±2.39) (P<0.05) .Conclusion:The TS-NSTEACS established based on Grace scoring in this study presents good reliability, validity and clinical effect;therefore, it is worthy of popularizing.
- GRACE score /
- NSTE-ACS /
- triage /
- scale

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