Value of Modified Early Warning Score Among Critically Ill Patients
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- Category: Vol. 78, December 2010
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Value of Modified Early Warning Score Among Critically Ill Patients,ASHRAF H. ABD AL MOHSEN and MOHAMED A. SHEHATA
Abstract
Background: The modified early warning score (MEWS) is a simple clinical scoring system suitable for bedside appli-cation used to predict patients who may undergo a cardio-respiratory arrest event at the onset of admission in the hospital.
Materials and Methods: The MEWS is a tool for bedside evaluation based on five physiological parameters. Systolic blood pressure, pulse rate, respiratory rate, temperature and AVPU score (A for "alert", V for reading to vocal stimuli, P for "reading to pain", U for "unconscious were recorded". The MEWS were applied to 100 newly admitted patients to ICU. A MEWS of 4 or more represent a Critical score. The highest score reached during period of admission was labeled "score max". The diagnostic validity test was calculated together with the receiver operator characteristic (ROC) curve.
Result: In a total of 100 ICU admissions there were 38 pts who had cardiopulmonary arrest whether died or survived (i.e. the arrested group = 38) and 62 patients hadn't cardiop-ulmonary arrest i.e. non arrested group = 62 patient.
The MEWS score max grade of 8 or more was associated with the highest rate of cardio respiratory arrest event (sensi-tivity 78.9%, specificity 93.5, accuracy 88%, area under ROC curve = 0.988. The mean and SD values of SBP, RR and AVPU score in the MEWS score max had a statistically significant difference between the arrested and the non arrested group patients (p-value <0.05).
Conclusion: The physiological variables which can be associated clinically remain the fast and the simplest way for patient evaluation. The modified early warning score (MEWS) is a physiological scoring system that can predict patients at risk of deterioration and subsequent development of cardio-respiratory arrest.