The Role of Modified Early Warning Score (MEWS) in the Prognosis of Acute Pancreatitis

Abstract

Objectives: Modified Early Warning Score (MEWS) is a reliable, safe, instant, and inexpensive score for prognosticating patients with acute pancreatitis (AP) due to its ability to reflect ongoing changes of the systemic inflammatory response syndrome associated with AP. Our study sought to determine an optimal MEWS value in predicting severity in AP and determine its accuracy in doing so. Methods: Patients diagnosed with AP and admitted to a single institution were analyzed to determine the value of MEWS in identifying severe AP (SAP). The highest MEWS (hMEWS) score for the day and the mean of all the scores of a given day (mMEWS) were determined for each day. Sensitivity, specificity, negative predictive value (NPV), and positive predictive values (PPV) were calculated for the optimal MEWS values obtained. Results: Two hundred patients were included in the study. The data suggested that an hMEWS value > 2 on day one is most accurate in predicting SAP, with a specificity of 90.8% and PPV of 83.3%. An mMEWS of > 1.2 on day two was the most accurate in predicting SAP, with a sensitivity of 81.2%, specificity of 76.6%, PPV of 69.8%, and NPV of 85.9%. These were found to be more accurate than previous studies. Conclusions: MEWS provides a novel, easy, instant, repeatable, and reliable prognostic score that is comparable, if not superior, to existing scoring systems. However, its true value may lie in its use in resource-limited settings such as primary health care centers.

Role of Modified Early Warning Score in Evaluating Mortality in Postoperative Period

“…Khan et al, conducted a study on the role of MEWS in the prognosis of acute pancreatitis and they found that with 90.8% of specificity and 83.3% of positive predictive value, the highest MEWS value >2 on day one is most accurate in predicting severe acute pancreatitis. Moreover, mean MEWS of >1.2 on day two was the most accurate in predicting severe acute pancreatitis, with a 6.6%, of specificity, 81.2% of sensitivity, 85.9% of negative predictive value, and positive predictive values of 69.8% [15].…”

Modified Early Warning Score: Clinical Deterioration of Mexican Patients Hospitalized with COVID-19 and Chronic Disease

“…Diabetes and hypertension were the main comorbidities. It should be noted that arterial hypertension and infectious processes increase the MEWS score when presenting fever, tachycardia, and hypertension, so it is recommended to use this score to predict the need for specific care [26]. In another study, hypertension was significantly associated with mortality in patients with COVID-19 [10].…”

The Latest Research Progress in the Application of MEWS Scoring System in Clinical Nursing

“…It shows that the MEWS score for patients with emergency cardiogenic chest pain can provide a reliable basis for predicting the short-term prognosis. In 2021, Amena Khan et al [15] applied the modified early warning score (MEWS) to the prognosis of acute pancreatitis in order to predict its severity. The results showed that the highest MEWS (hMEWS) score > 2, and the average of all scores on the day (mMEWS) > 1.2 was the most accurate in predicting severe acute pancreatitis, and these findings were more accurate than previous studies.…”