Predictive value of the modified Early Warning Score in a Turkish emergency department

Abstract

We conclude that scores on the mEWS predict ICU admission as well as ICU and in-hospital deaths.

Strengths and limitations of early warning scores: A systematic review and narrative synthesis

“…One prospective study examined the MEWS of 309 patients presenting to a Turkish ED and found that patients with a MEWS of 5 or more were 1.95 times more likely to be admitted to ICU than those with a MEWS < 5, and 35 times more likely to die in the ED and 14 times more likely to die in hospital. 15 A group in Amsterdam retrospectively analysed the MEWS of 204 medical and surgical patients who had experienced a 'severe adverse event,' including cardiopulmonary arrest, unplanned ICU admission, emergency surgery or unexpected death. Eighty one percent of patients had an MEWS value of 3 or more at least once during the 48 hours before their event.…”

A combination of clinical parameters and blood–gas analysis identifies patients at risk of transfer to intensive care upon arrival to the Emergency Department

“…This may be because of the fact that other studies included both transfer to the ICU and death as an outcome [8,10,[15][16][17]. For the surgical patients, age was associated with transfer to the ICU, which has been reported previously [12,13].…”

“…Several other studies [10,[14][15][16] have found level of consciousness to be a good indicator of poor outcome. We did not find this, probably because the aim of our study differed in the way in which we sought early predictors of later deterioration.…”

“…Several algorithms have been developed to predict patient outcome in different settings, such as the ICU or the general ward. Algorithms developed for use in the ED are either based on data from very small or restricted groups of patients, such as medical or elderly patients, or based on elaborate laboratory tests or serial measurements [5][6][7][8][9][10][11][12][13][14][15][16][17]. These studies find level of consciousness, systolic blood pressure and respiratory frequency to be good indicators of later clinical deterioration and/or need for intensive care [8,10,14,15,17].…”

Is the Modified Early Warning Score able to enhance clinical observation to detect deteriorating patients earlier in an Accident & Emergency Department?

“…19,20 Two studies focused on predicting medical, intensive care unit admission and death at the ED triage area which were conducted retrospectively. 21,22 No study was found to evaluate serial measurements of the MEWS overtime for ED patients. A prospective cohort study in the authors' ED validated the effectiveness of the MEWS for a heterogeneous group of patients over time but it is done in the emergency medicine ward instead of the main ED patient area.…”