Predictive Value of Modified Early Warning Scoring System for Identifying Critical Patients with Malignancy in...

Area of Science:

• Emergency Medicine
• Oncology
• Critical Care

Background:

• Early identification of critically ill patients in the emergency department (ED) is crucial.
• Delays in intensive care service delivery are linked to increased patient mortality.
• Patients with malignancy present unique challenges in critical care settings.

Purpose of the Study:

• To assess the effectiveness of the Modified Early Warning Score (MEWS) in identifying critically ill cancer patients within the ED.
• To determine if MEWS can predict 30-day mortality in patients with malignancy admitted to the ED.

Main Methods:

• A prospective study evaluated patients with malignancy admitted to a tertiary university hospital's ED over three months.
• Modified Early Warning Score (MEWS) was recorded upon admission (MEWS1) and two hours later (MEWS2).
• Patients were followed for 30 days to record mortality outcomes.

Main Results:

• MEWS scores were significantly higher on admission (MEWS1) compared to two hours later (MEWS2) (P < 0.001).
• MEWS scores were significantly higher in patients who died within 30 days compared to survivors (P < 0.001).
• Receiver Operating Characteristic (ROC) analysis showed an Area Under the Curve (AUC) of 0.900 for mortality prediction with MEWS1, identifying a cut-off value of 2.

Conclusions:

• Modified Early Warning Score (MEWS) is a valuable tool for predicting 30-day mortality in cancer patients presenting to the ED.
• MEWS facilitates the identification of high-risk patients, enabling timely critical care interventions.
• The study suggests that MEWS, along with AVPU scores, can aid in mortality prediction for ED patients.