A Protocolised Once a Day Modified Early Warning Score (MEWS) Measurement Is an Appropriate Screening Tool for Major Adverse Events in a General Hospital Population
| Autor: | Jeroen Ludikhuize, Mark H. H. Kramer, Louise S. van Galen, Prabath W. B. Nanayakkara, Casper C. Dijkstra |
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| Přispěvatelé: | Internal medicine, ICaR - Circulation and metabolism, AII - Amsterdam institute for Infection and Immunity, ANS - Amsterdam Neuroscience, Anesthesiology |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Critical Care and Emergency Medicine Medical Doctors Health Care Providers Nurses lcsh:Medicine Severity of Illness Index Infographics 0302 clinical medicine Medicine and Health Sciences Health Status Indicators Hospital Mortality Prospective Studies 030212 general & internal medicine lcsh:Science Trauma Medicine education.field_of_study Multidisciplinary Mortality rate Middle Aged Early warning score Charts Hospitals Professions Research Design Female Risk assessment Research Article Computer and Information Sciences medicine.medical_specialty Clinical Research Design Death Rates Critical Illness Trauma Surgery Population Surgical and Invasive Medical Procedures Documentation Hospitals General Research and Analysis Methods Risk Assessment 03 medical and health sciences Population Metrics Severity of illness medicine Humans Intensive care medicine education Adverse effect Aged Demography Population Biology business.industry Data Visualization lcsh:R Biology and Life Sciences 030208 emergency & critical care medicine Health Care Mews Early Diagnosis Health Care Facilities People and Places Emergency medicine Population Groupings lcsh:Q Adverse Events business Trauma surgery |
| Zdroj: | PLoS ONE, 11(8). Public Library of Science PLoS ONE, Vol 11, Iss 8, p e0160811 (2016) PLoS ONE van Galen, L S, Dijkstra, C C, Ludikhuize, J, Kramer, M H H & Nanayakkara, P W B 2016, ' A Protocolised Once a Day Modified Early Warning Score (MEWS) Measurement Is an Appropriate Screening Tool for Major Adverse Events in a General Hospital Population ', PLoS ONE, vol. 11, no. 8, pp. e0160811 . https://doi.org/10.1371/journal.pone.0160811 |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0160811 |
| Popis: | BACKGROUND: The Modified Early Warning Score (MEWS) was developed to timely recognise clinically deteriorating hospitalised patients. However, the ability of the MEWS in predicting serious adverse events (SAEs) in a general hospital population has not been examined prospectively. The aims were to (1) analyse protocol adherence to a MEWS protocol in a real-life setting and (2) to determine the predictive value of protocolised daily MEWS measurement on SAEs: death, cardiac arrests, ICU-admissions and readmissions.METHODS: All adult patients admitted to 6 hospital wards in October and November 2015 were included. MEWS were checked each morning by the research team. For each critical score (MEWS ≥ 3), the clinical staff was inquired about the actions performed. 30-day follow-up for SAEs was performed to compare between patients with and without a critical score.RESULTS: 1053 patients with 3673 vital parameter measurements were included, 200 (19.0%) had a critical score. The protocol adherence was 89.0%. 18.2% of MEWS were calculated wrongly. Patients with critical scores had significant higher rates of unplanned ICU admissions [7.0% vs 1.3%, p < 0.001], in-hospital mortality [6.0% vs 0.8%, p < 0.001], 30-day readmission rates [18.6% vs 10.8%, p < 0.05], and a longer length of stay [15.65 (SD: 15.7 days) vs 6.09 (SD: 6.9), p < 0.001]. Specificity of MEWS related to composite adverse events was 83% with a negative predicting value of 98.1%.CONCLUSIONS: Protocol adherence was high, even though one-third of the critical scores were calculated wrongly. Patients with a MEWS ≥ 3 experienced significantly more adverse events. The negative predictive value of early morning MEWS < 3 was 98.1%, indicating the reliability of this score as a screening tool. |
| Databáze: | OpenAIRE |
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