Retrospective analysis of the positive effect of emergency room national early warning score 2 on descending necrotizing mediastinitis patients
摘要
A retrospective analysis of patients with descending necrotizing mediastinum (DNM) admitted to the emergency department was performed to improve emergency physicians’ knowledge of DNM, so as to achieve early judgment and timely resuscitation of DNM and to avoid delays in the diagnosis and treatment of patients. We explored the use of the NEWS2 to assess the condition of DNM patients, hoping to enable timely treatment and prevent adverse events.
MethodsA retrospective review was conducted on the clinical data of 30 patients who were admitted to our hospital and ultimately diagnosed with DNM between 2014 and 2023. NEWS2 were calculated based on the clinical data of DNM patients at the time of emergency admission. Patients were then grouped according to their scores to explore the relationship between the score and adverse events during hospitalization as well as prognosis.
ResultsA total of 30 DNM patients were included, 22 of whom were male (73.3%). The median age was 53 years (range: 47.75 to 62.50 years). Seven patients were diagnosed upon emergency admission, while 23 had an undetermined diagnosis, yielding an emergency department misdiagnosis rate of 76.7%. According to the NEWS2, 19 patients were classified into the low-risk group, 6 into the medium-risk group, and 5 into the high-risk group. During hospitalization, 14 patients (46.7%) experienced critical events, including 2 cases of cardiac arrest. Thirteen patients (43.3%) developed secondary sepsis, with incidence rates of 31.6%, 66.7%, and 60.0% in the low-risk, medium-risk, and high-risk groups, respectively. Eleven patients died: 5 in the low-risk group (26.3%), 2 in the medium-risk group (33.3%), and 4 in the high-risk group (80.0%).