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The value of Modified Early Warning Score (MEWS) in surgical in-patients: a prospective observational study
J Gardner-Thorpe1, N Love, J Wrightson
1Department of Surgery, Addenbrooke's Hospital, Cambridge, UK. jamesgt@doctors.org.uk
Introduction:
The Modified Early Warning Score (MEWS) is a simple, physiological score that may allow improvement in the quality and safety of management provided to surgical ward patients. The primary purpose is to prevent delay in intervention or transfer of critically ill patients.
Patients And Methods:
A total of 334 consecutive ward patients were prospectively studied. MEWS were recorded on all patients and the primary end-point was transfer to ITU or HDU.
Results:
Fifty-seven (17%) ward patients triggered the call-out algorithm by scoring four or more on MEWS. Emergency patients were more likely to trigger the system than elective patients. Sixteen (5% of the total) patients were admitted to the ITU or HDU. MEWS with a threshold of four or more was 75% sensitive and 83% specific for patients who required transfer to ITU or HDU.
Conclusions:
The MEWS in association with a call-out algorithm is a useful and appropriate risk-management tool that should be implemented for all surgical in-patients.
Insights
The Modified Early Warning Score (MEWS) effectively identifies surgical patients needing critical care, with a threshold of four or more showing high sensitivity and specificity for transfer to intensive or high-dependency units. This tool aids in timely intervention for deteriorating patients.
Area of Science:
- Medical Sciences
- Clinical Practice
- Patient Safety
Background:
- The Modified Early Warning Score (MEWS) is a physiological scoring system.
- It aims to enhance the quality and safety of care for surgical ward patients.
- MEWS is designed to prevent delayed interventions or transfers for critically ill patients.
Purpose of the Study:
- To evaluate the effectiveness of the Modified Early Warning Score (MEWS) in surgical ward patients.
- To determine if MEWS can predict the need for transfer to an Intensive Therapy Unit (ITU) or High Dependency Unit (HDU).
Main Methods:
- A prospective study of 334 consecutive surgical ward patients.
- MEWS were systematically recorded for all patients.
- The primary endpoint was the transfer of patients to ITU or HDU.
Main Results:
- 17% of patients (57/334) triggered the MEWS call-out algorithm (score ≥ 4).
- Emergency patients were more likely to trigger the MEWS system than elective patients.
- 16 patients (5%) were admitted to ITU or HDU; MEWS (≥ 4) demonstrated 75% sensitivity and 83% specificity for this outcome.
Conclusions:
- The MEWS, combined with a call-out algorithm, is a valuable risk management tool.
- It is recommended for implementation in the care of all surgical in-patients.
- This approach can improve the timely identification and management of critically ill surgical patients.