Performance of Modified Early Warning Score (MEWS) for Predicting In-Hospital Mortality in Traumatic Brain Injury Patients
| Autor: | Jun-Ho Han, Seok-Jin Ryu, Byung Kook Lee, Ji Ho Lee, Yong-Hun Jung, Dong Ki Kim, Yong Soo Cho, Dong Hun Lee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Abbreviated Injury Scale business.industry traumatic brain injury Glasgow Coma Scale scoring system 030208 emergency & critical care medicine Retrospective cohort study modified early warning score General Medicine Revised Trauma Score Early warning score mortality Article Confidence interval Mews 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Injury Severity Score Medicine 030212 general & internal medicine business |
| Zdroj: | Journal of Clinical Medicine, Vol 10, Iss 1915, p 1915 (2021) Journal of Clinical Medicine Volume 10 Issue 9 |
| ISSN: | 2077-0383 |
| Popis: | The present study aimed to analyze and compare the prognostic performances of the Revised Trauma Score (RTS), Injury Severity Score (ISS), Shock Index (SI), and Modified Early Warning Score (MEWS) for in-hospital mortality in patients with traumatic brain injury (TBI). This retrospective observational study included severe trauma patients with TBI who visited the emergency department between January 2018 and December 2020. TBI was considered when the Abbreviated Injury Scale was 3 or higher. The primary outcome was in-hospital mortality. In total, 1108 patients were included, and the in-hospital mortality was 183 patients (16.3% of the cohort). Receiver operating characteristic curve analyses were performed for the ISS, RTS, SI, and MEWS with respect to the prediction of in-hospital mortality. The area under the curves (AUCs) of the ISS, RTS, SI, and MEWS were 0.638 (95% confidence interval (CI), 0.603–0.672), 0.742 (95% CI, 0.709–0.772), 0.524 (95% CI, 0.489–0.560), and 0.799 (95% CI, 0.769–0.827), respectively. The AUC of MEWS was significantly different from the AUCs of ISS, RTS, and SI. In multivariate analysis, age (odds ratio (OR), 1.012 95% CI, 1.000–1.023), the ISS (OR, 1.040 95% CI, 1.013–1.069), the Glasgow Coma Scale (GCS) score (OR, 0.793 95% CI, 0.761–0.826), and body temperature (BT) (OR, 0.465 95% CI, 0.329–0.655) were independently associated with in-hospital mortality after adjustment for confounders. In the present study, the MEWS showed fair performance for predicting in-hospital mortality in patients with TBI. The GCS score and BT seemed to have a significant role in the discrimination ability of the MEWS. The MEWS may be a useful tool for predicting in-hospital mortality in patients with TBI. |
| Databáze: | OpenAIRE |
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