Abstract

Objective: The Modified Early Warning Score (MEWS) is a simple physiological scoring system, which can easily be applied at the bedside. The ability of MEWS to identify patients at risk of deterioration in a busy ward.

Method: In a prospective cohort study, we applied MEWS to patients admitted to the Internal medicine department of Kon Tum general hospital. In this study, we investigate the relative contributions of the ventilatory frequency, heart rate, arterial pressure, temperature, and conscious level to mortality in order to devise a robust scoring system. All data were collected on admission to the emergency unit. Precise 'MEWS scores' could then be derived to trigger interventions. Statistical analysis of the data were performed using Medcal sotfware.

Results: Data on 110 in-patients were collected from October 2010 to October 2011. 39 patients were death, intensive care unit (ICU) admission and 71 patiens inpatient hospital admission. MEWS with a threshold of four or more was 25.6% sensitive and 88.7% specific for patients who required transfer to.

ITU or HDU. Scores of MEWS >= 4 were associated with increased risk of death and ICU admission at Oh (OR 2,27; 95% CI = 0,97 – 5,29) and at 12h (OR 29,12; CI=4,01 — 211,43).

Conclusion: MEWS is suitable for bedside application in clinical and may help identify patients at risk of deterioration who require increased levels of care as hospital inpatients and in ICU. The use of the MEWS system may aid close monitoring and identification of high-risk patients.