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目的探讨修正CRAMS评分法对创伤患者院前救治评估的可行性。方法 1273例急诊创伤患者,对其进行标准CRAMS评分及修正CRAMS评分,将修正前后CRAMS评分与创伤严重程度特征评价方法 (ASCOT)进行一致性分析。结果修正CRAMS评分组与标准CRAMS评分组创伤类型比较差异无统计学意义(P>0.05)。经一致性检验,标准CRAMS评分与ASCOT评分的一致性好(Kappa=0.870,P<0.05);而修正CRAMS评分与ASCOT评分的一致性好(Kappa=0.941,P<0.05),修正后的CRAMS评分与ASCOT评分的一致性要高于标准CRAMS评分。结论修正CRAMS创伤评估法可能在院前创伤评估中更准确,可有效降低创伤患者的病死率,提高抢救成功率。
Objective To investigate the feasibility of ameliorating CRAMS score in prehospital evaluation of trauma patients. Methods A total of 1273 emergency trauma patients were evaluated by CRAMS and CRAMS scores. Consistency analysis was performed between the CRAMS score before and after CROSA and the severity of trauma (ASCOT). Results There was no significant difference in the type of trauma between CRAMS and CRAMS (P> 0.05). The concordance test showed that the standard CRAMS score was consistent with ASCOT score (Kappa = 0.870, P <0.05), while the consistency between modified CRAMS score and ASCOT score was good (Kappa = 0.941, P <0.05) The score is more consistent with the ASCOT score than the standard CRAMS score. Conclusion The revised CRAMS trauma assessment method may be more accurate in prehospital trauma assessment, which can effectively reduce the mortality of trauma patients and improve the success rate of rescue.