Modified Early Warning Score as a predictor of intensive care unit readmission within 48 hours: a retrospective observational study.

Autor: Balshi AN; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Huwait BM; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Noor ASN; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Alharthy AM; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Madi AF; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Ramadan OE; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Balahmar A; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Mhawish HA; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Marasigan BR; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Alcazar AM; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia., Rana MA; Internal Medicine and Critical Care Department, Bahria Town International Hospital, Lahore, Pakistan., Aletreby WT; Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Jazyk: English; Portuguese
Zdroj: Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2020 Jun; Vol. 32 (2), pp. 301-307. Date of Electronic Publication: 2020 Jul 13.
DOI: 10.5935/0103-507x.20200047
Abstrakt: Objective: To evaluate the hypothesis that the Modified Early Warning Score (MEWS) at the time of intensive care unit discharge is associated with readmission and to identify the MEWS that most reliably predicts intensive care unit readmission within 48 hours of discharge.
Methods: This was a retrospective observational study of the MEWSs of discharged patients from the intensive care unit. We compared the demographics, severity scores, critical illness characteristics, and MEWSs of readmitted and non-readmitted patients, identified factors associated with readmission in a logistic regression model, constructed a Receiver Operating Characteristic (ROC) curve of the MEWS in predicting the probability of readmission, and presented the optimum criterion with the highest sensitivity and specificity.
Results: The readmission rate was 2.6%, and the MEWS was a significant predictor of readmission, along with intensive care unit length of stay > 10 days and tracheostomy. The ROC curve of the MEWS in predicting the readmission probability had an AUC of 0.82, and a MEWS > 6 carried a sensitivity of 0.78 (95%CI 0.66 - 0.9) and specificity of 0.9 (95%CI 0.87 - 0.93).
Conclusion: The MEWS is associated with intensive care unit readmission, and a score > 6 has excellent accuracy as a prognostic predictor.
Databáze: MEDLINE
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