Evaluating the Use of a Modified Early Warning Score in Predicting Serious Adverse Events in Iranian Hospitalized Patients: A Prognostic Study

Assessment of early clinical warning signs and appropriate response can prevent serious adverse events in hospitalized patients. The Modified Early Warning Score (MEWS) is an applicable early warning sign system that can be used to predict serious adverse events. This study aimed to evaluate the pre...

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Bibliographic Details
Published in:Journal of emergency nursing 2020-01, Vol.46 (1), p.72-82
Main Authors: Maftoohian, Maryam, Assarroudi, Abdolghader, Stewart, Jacqueline J., Dastani, Mostafa, Rakhshani, Mohammad Hassan, Sahebkar, Mohammad
Format: Article
Language:English
Subjects:
Adverse
Blood pressure
Clinical assessment
Clinical outcomes
Consciousness
Critical care
Critical incidents
Emergency medical care
Emergency services
Heart rate
Hospitalization
Inpatient care
Medical prognosis
Modified Early Warning Score
Nursing
Ostomy
Patient admissions
Patients
Predictive value of tests
Sensitivity and specificity
Serious adverse events
Vital signs
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Summary:Assessment of early clinical warning signs and appropriate response can prevent serious adverse events in hospitalized patients. The Modified Early Warning Score (MEWS) is an applicable early warning sign system that can be used to predict serious adverse events. This study aimed to evaluate the predictive capacity of the MEWS to identify patients in an Iranian hospital who are at risk of developing serious adverse events. In this prognostic study, 381 adult patients from the emergency department who were admitted to an inpatient hospital unit of an Iranian hospital from May 2018 to October 2018 were included. The MEWS tool was completed for each patient at the time of admission and then daily for a period of up to 30 continuous days after admission or until the development of a serious adverse event. Receiver operating characteristic, specificity, sensitivity, positive predictive values, and negative predictive values were calculated. In this study, a MEWS of ≥3 on admission was associated with an increased likelihood of developing serious adverse events within 30 days of admission with the area under the curve of 0.82 (95% confidence interval [CI]: 0.77–0.85), sensitivity of 82.81% (95% CI: 71.3–91.1), specificity of 75.39% (95% CI: 70.3–80), positive predictive value of 40.5% (95% CI: 35.2–45.9), and negative predictive value of 95.6% (95% CI: 92.7–97.4). A MEWS ≥3 on admission can predict the occurrence of serious averse events in patients admitted to an Iranian hospital for 30 continuous days.
ISSN:0099-1767
1527-2966
DOI:10.1016/j.jen.2019.10.015