Prognostic value of National Early Warning Score and Modified Early Warning Score on intensive care unit readmission and mortality: A prospective observational study.
Modified Early Warning Score
National Early Warning Score
intensive care unit
mortality
prognosis
readmission
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
06
05
2022
accepted:
19
07
2022
entrez:
22
8
2022
pubmed:
23
8
2022
medline:
23
8
2022
Statut:
epublish
Résumé
Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS) are widely used in predicting the mortality and intensive care unit (ICU) admission of critically ill patients. This study was conducted to evaluate and compare the prognostic value of NEWS and MEWS for predicting ICU readmission, mortality, and related outcomes in critically ill patients at the time of ICU discharge. This multicenter, prospective, observational study was conducted over a year, from April 2019 to March 2020, in the general ICUs of two university-affiliated hospitals in Northwest Iran. MEWS and NEWS were compared based on the patients' outcomes (including mortality, ICU readmission, time to readmission, discharge type, mechanical ventilation (MV), MV duration, and multiple organ failure after readmission) using the univariable and multivariable binary logistic regression. The receiver operating characteristic (ROC) curve was used to determine the outcome predictability of MEWS and NEWS. A total of 410 ICU patients were enrolled in this study. According to multivariable logistic regression analysis, both MEWS and NEWS were predictors of ICU readmission, time to readmission, MV status after readmission, MV duration, and multiple organ failure after readmission. The area under the ROC curve (AUC) for predicting mortality was 0.91 (95% CI = 0.88-0.94, National Early Warning Score and MEWS values of >4 demonstrated high sensitivity and specificity in identifying the risk of mortality for the patients' discharge from ICU. However, we found that the MEWS showed superiority over the NEWS score in predicting other outcomes. Eventually, MEWS could be considered an efficient prediction score for morbidity and mortality of critically ill patients.
Sections du résumé
Background
UNASSIGNED
Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS) are widely used in predicting the mortality and intensive care unit (ICU) admission of critically ill patients. This study was conducted to evaluate and compare the prognostic value of NEWS and MEWS for predicting ICU readmission, mortality, and related outcomes in critically ill patients at the time of ICU discharge.
Methods
UNASSIGNED
This multicenter, prospective, observational study was conducted over a year, from April 2019 to March 2020, in the general ICUs of two university-affiliated hospitals in Northwest Iran. MEWS and NEWS were compared based on the patients' outcomes (including mortality, ICU readmission, time to readmission, discharge type, mechanical ventilation (MV), MV duration, and multiple organ failure after readmission) using the univariable and multivariable binary logistic regression. The receiver operating characteristic (ROC) curve was used to determine the outcome predictability of MEWS and NEWS.
Results
UNASSIGNED
A total of 410 ICU patients were enrolled in this study. According to multivariable logistic regression analysis, both MEWS and NEWS were predictors of ICU readmission, time to readmission, MV status after readmission, MV duration, and multiple organ failure after readmission. The area under the ROC curve (AUC) for predicting mortality was 0.91 (95% CI = 0.88-0.94,
Conclusion
UNASSIGNED
National Early Warning Score and MEWS values of >4 demonstrated high sensitivity and specificity in identifying the risk of mortality for the patients' discharge from ICU. However, we found that the MEWS showed superiority over the NEWS score in predicting other outcomes. Eventually, MEWS could be considered an efficient prediction score for morbidity and mortality of critically ill patients.
Identifiants
pubmed: 35991649
doi: 10.3389/fmed.2022.938005
pmc: PMC9386480
doi:
Types de publication
Journal Article
Langues
eng
Pagination
938005Informations de copyright
Copyright © 2022 Mahmoodpoor, Sanaie, Saghaleini, Ostadi, Hosseini, Sheshgelani, Vahedian-Azimi, Samim and Rahimi-Bashar.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Implement Sci. 2013 Jun 14;8:67
pubmed: 23767696
QJM. 2001 Oct;94(10):521-6
pubmed: 11588210
Yonsei Med J. 2015 Mar;56(2):543-9
pubmed: 25684007
Crit Care. 2013 Jun 29;17(3):R102
pubmed: 23718698
BJA Educ. 2019 Jul;19(7):212-218
pubmed: 33456893
J Clin Nurs. 2018 Apr;27(7-8):1360-1368
pubmed: 29266536
PeerJ. 2020 Sep 28;8:e10018
pubmed: 33062437
JAMA Netw Open. 2020 May 1;3(5):e205191
pubmed: 32427324
Clin Interv Aging. 2021 Oct 28;16:1917-1929
pubmed: 34737556
JAMA. 2013 Nov 27;310(20):2191-4
pubmed: 24141714
Crit Care Med. 2013 Jan;41(1):24-33
pubmed: 23128381
Eur J Anaesthesiol. 2012 Mar;29(3):152-7
pubmed: 22273831
Dan Med J. 2018 Feb;65(2):
pubmed: 29393044
Eur J Intern Med. 2017 Nov;45:20-31
pubmed: 28993097
Am J Respir Crit Care Med. 2012 May 1;185(9):955-64
pubmed: 22281829
Clin Med (Lond). 2012 Dec;12(6):501-3
pubmed: 23342400
Emerg Med J. 2008 Oct;25(10):674-8
pubmed: 18843068
BMJ Open. 2018 Dec 14;8(12):e024120
pubmed: 30552276
Ir J Med Sci. 2022 Jun;191(3):997-1003
pubmed: 34184206
Wiad Lek. 2019;72(7):1387-1396
pubmed: 31398174
Arch Dis Child. 2019 Apr;104(4):395-399
pubmed: 30413488
J Intensive Care. 2015 Jun 26;3(1):30
pubmed: 26157581
Ann Am Thorac Soc. 2015 Jun;12(6):886-94
pubmed: 25822477
J Trauma Acute Care Surg. 2019 Jul;87(1S Suppl 1):S67-S73
pubmed: 31246909
BMC Health Serv Res. 2017 Apr 17;17(1):281
pubmed: 28416016
Crit Care Med. 2015 May;43(5):1053-61
pubmed: 25756416
J Clin Epidemiol. 2008 Apr;61(4):344-9
pubmed: 18313558
Ther Clin Risk Manag. 2019 Feb 25;15:315-322
pubmed: 30880997
PLoS One. 2012;7(11):e48758
pubmed: 23144958
Int J Clin Pract. 2009 Apr;63(4):591-5
pubmed: 19220521
Turk J Med Sci. 2020 Jul 14;50(5):1203-1209
pubmed: 32659876
Resuscitation. 2014 May;85(5):587-94
pubmed: 24467882
J Crit Care. 2012 Aug;27(4):422.e1-9
pubmed: 22172798
Acta Anaesthesiol Scand. 2019 May;63(5):676-683
pubmed: 30623422
Ann Am Thorac Soc. 2017 Aug;14(8):1312-1319
pubmed: 28530118
Intensive Crit Care Nurs. 2014 Jun;30(3):121-37
pubmed: 24308898
Rev Bras Ter Intensiva. 2020 Jun;32(2):301-307
pubmed: 32667433