Please use this identifier to cite or link to this item: http://hdl.handle.net/11452/34442
Title: Predictive value of modified early warning scoring system for identifying critical patients with malignancy in emergency department
Authors: Aygün, Hüseyin
Eraybar, Suna
Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü.
Özdemir, Fatma
Armağan, Erol
IOY-2055-2023
AAH-8846-2021
7006765911
6506464232
Keywords: General & internal medicine
Critical patient
Emergency department
Malignancy
Mews
Medical patients
ILL patients
Apache-II
Care
Mortality
Admission
Coma
Consciousness
Morbidity
Scale
Issue Date: Aug-2020
Publisher: ACAD Medical Sciences
Citation: Aygün, H. vd. (2020). "Predictive value of modified early warning scoring system for identifying critical patients with malignancy in emergency department". Archives of Iranian Medicine, 23(8), 536-541.
Abstract: Background: Identification of critically ill patient is particularly important in the emergency department (ED). The prolonged duration from hospital admission to delivering intensive care service is related to increased mortality. The aim of this study is to evaluate the effectiveness of Modified Early Warning Score (MEWS) for identifying critical patients with malignancy in ED settings. Methods: We evaluated patients with malignancy who were admitted to our ED of a tertiary university hospital in Turkey over a three-month period. We evaluated MEWS on admission as MEWS 1. After the initial treatment depending on the patients' health status in ED, at 2 hours after admission, we evaluated MEWS again and recorded as MEWS 2. All patients were followed up for 30 days after the initial admission. Results: Mean age (SD) was 59.2 (13.5) and male/female ratio was 295/206. MEWS1 was higher than MEWS2, (MEWS1: 3.05 3.31, MEWS2: 2.35 +/- 3.17, P < 0.001). A total of 362 patients (72.3%) survived and 139 (27.7%) died within 30 days of initial admission. MEWS1/MEWS2 values for alive and dead patients were 1.66/0.87, and 6.67/6.21, respectively, and the difference was significant (P < 0.001). ROC analysis was performed for MEWS 1; the area under curve (AUC) for hospitalization was 0.768 (95% CI 0.729 to 0.804) and for mortality was 0.900 (95% CI 0.870 to 0.924). ROC analysis revealed a cut-off value of 2 for predicting both hospitalization and mortality in these patients. The sensitivity of the presented cut-off was 77.32% (72.1%-82.0%) for hospitalization and 76.24% (95% CI 71.5-80.5) for mortality; the specificity was 69.52 (95% CI 62.8-75.7) for hospitalization and 90.65 (95% CI 84.65-94.9) for mortality. Conclusion: We found in our study that MEWS evaluation for patients with malignancy on admission to ED is predictive of mortality in the subsequent 30 days, and it is a valuable tool for identifying the critical group. Also, AVPU scores alone can predict mortality in patients admitted to ED.
URI: https://doi.org/10.34172/aim.2020.56
https://www.semanticscholar.org/reader/265832e6b45ca3d0dcfa7ca50adee8d368024e6e
http://hdl.handle.net/11452/34442
ISSN: 1029-2977
1735-3947
Appears in Collections:Scopus
Web of Science

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