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Periarrest Modified Early Warning Score (MEWS) predicts the outcome of in-hospital cardiac arrest
- Source :
- Journal of the Formosan Medical Association, Vol 115, Iss 2, Pp 76-82 (2016)
- Publication Year :
- 2016
- Publisher :
- Elsevier, 2016.
-
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.
- Subjects :
- Male
medicine.medical_specialty
Taiwan
Logistic regression
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
Severity of illness
medicine
Humans
Hospital Mortality
030212 general & internal medicine
Intensive care medicine
Aged
Retrospective Studies
Aged, 80 and over
Medicine(all)
lcsh:R5-920
business.industry
030208 emergency & critical care medicine
Retrospective cohort study
General Medicine
Emergency department
Middle Aged
Prognosis
Early warning score
Triage
Confidence interval
Heart Arrest
Hospitalization
Mews
Logistic Models
Multivariate Analysis
Emergency medicine
Female
in-hospital cardiac arrest
Modified Early Warning Score
Emergency Service, Hospital
business
lcsh:Medicine (General)
Subjects
Details
- Language :
- English
- ISSN :
- 09296646
- Volume :
- 115
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of the Formosan Medical Association
- Accession number :
- edsair.doi.dedup.....2963964f5ba10ff80c8b89c6464566a4