Periarrest Modified Early Warning Score (MEWS) predicts the outcome of in-hospital cardiac arrest
Journal
Journal of the Formosan Medical Association
Journal Volume
115
Journal Issue
2
Pages
76-82
Date Issued
2016
Author(s)
Abstract
Background/Purpose: The Modified Early Warning Score (MEWS) reflects the physiological changes of cardiac arrest and has been used in identifying patient deterioration. Physiological reserve capacity is an important outcome predictor, but is seldom reported due to recording limitations in cardiac arrest patients. The aim of the study was to evaluate whether periarrest MEWS could be a further prognostic factor in in-hospital cardiac arrest. Methods: This was a retrospective cohort study of nontrauma adult patients who had experienced in-hospital cardiac arrest during emergency department stays at an urban, 2600-bed tertiary medical center in Taiwan from February 2011 to July 2013. Data regarding patients' characteristics, Charlson Comorbidity Score, MEWS score before events, mode of arrest, and outcome details were extracted following the Utstein guidelines for uniform reporting of cardiac arrest. Results: During the 30-month period, 234 patients suffered in-hospital cardiac arrest during emergency department stays, and 99 patients with periarrest MEWS were included in the final analysis. The MEWS at triage did not differ significantly between survival-to-discharge and mortality groups (3.42 ± 2.2 vs. 4.02 ± 2.65, p = 0.811). Periarrest MEWS was lower in the survival-to-discharge group (4.41 ± 2.28 vs. 5.82 ± 2.84, p = 0.053). In multivariate logistic regression analysis, periarrest MEWS was an independent predictors for survival to discharge. A rise in periarrest MEWS reduced the chance of survival to discharge by 0.77-fold (95% confidence interval: 0.60-0.97, p = 0.028). Conclusion: The simplest MEWS system not only can be used as a prevention measure, but the periarrest MEWS could also be considered as an independent predictor of mortality after in-hospital cardiac arrest. ? 2015.
SDGs
Other Subjects
adult; aged; Article; body temperature; breathing rate; cohort analysis; consciousness level; emergency ward; female; heart arrest; heart rate; human; in hospital cardiac arrest; major clinical study; male; mortality; multivariate logistic regression analysis; outcome assessment; Periarrest Modified Early Warning Score; prediction; retrospective study; scoring system; systolic blood pressure; emergency health service; heart arrest; hospital emergency service; hospital mortality; hospitalization; middle aged; multivariate analysis; pathophysiology; procedures; prognosis; severity of illness index; statistical model; Taiwan; very elderly; Aged; Aged, 80 and over; Emergency Service, Hospital; Female; Heart Arrest; Hospital Mortality; Hospitalization; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prognosis; Retrospective Studies; Severity of Illness Index; Taiwan; Triage
Type
journal article