Abstract: Objective To explore trends of the National Early Warning Scores (NEWS) 24h prior to in-hospital cardiac arrest (IHCA) for patients with acute coronary syndromes (ACS). Methods We conducted a retrospective case-control study in 3 tertiary hospitals in Fujian Province,patients with ACS who experienced cardiac arrest were in the case group. We randomly selected patients with ACS who had not experienced cardiac arrest as the control group. The NEWS was calculated at 24h,16h,8h,1h and 0.5h before cardiac arrest and the trends were analyzed. Results The NEWS were significantly different between the case group and the control group at 24h,16h, 8h, 1h and 0.5h before cardiac arrest, the scores in the case group were higher than those in the control group, and the trend was continuingly rising (P<0.001). The proportion of high-risk NEWS group was enlarged before cardiac arrest (from 24h to 0.5 h,NEWS increased from 11.6% to 36.62), and the proportion of low-risk NEWS group was smaller (from 24h to 0.5h,NEWS decreased from 67.7% to 21.4%). From 24h to 0.5h prior to cardiac arrest, compared to low-risk group, the incidence of cardiac arrest of high-risk group was increased from 7.00 times to 56.57 times. Conclusion The NEWS can properly predict cardiac arrest among patients with ACS, and can better identify high-risk patients.

Key words: Early Warning Score, Acute Coronary Syndrome, Heart Arrest

摘要： 目的 探讨急性冠状动脉综合征(acute coronary syndromes, ACS)患者发生心搏骤停前24h英国国家早期预警评分（National Early Warning Score,NEWS)的变化趋势。方法 采取病例对照研究的方法，选取福建省3所三级甲等医院发生心搏骤停的ACS患者为病例组，随机选取未发生心搏骤停的ACS患者为对照组。分析心搏骤停发生前24h各时间点两组之间NEWS分值的差异及24h的变化趋势。结果 在心搏骤停发生前24h、16h、8h、1h和0.5h,两组之间的NEWS分值差异均具有统计意义,病例组均高于对照组，呈持续上升的趋势(P<0.001)。在病例组中，越接近心搏骤停的发生，高危组所占的比重从心搏骤停前24h的11.6%升高至0.5h前的36.6%,低危组所占的比重从心搏骤停前24h的67.7%减少至0.5h前的21.4%,而对照组无明显变化。从心搏骤停发生前24h至0.5h,高危组发生心搏骤停的概率是低危组的7.00倍逐渐上升至56.57倍。结论 NEWS能较好地预测心搏骤停的发生，应将NEWS应用于临床，识别发生心搏骤停潜在的高危患者。

关键词: 早期预警评分, 急性冠状动脉综合征, 心脏停搏