Modified Early Warning Score as a predictor of intensive care unit readmission within 48 hours: a retrospective observational study.

Modified Early Warning Score como preditor de readmissão à unidade de terapia intensiva dentro de 48 horas: um estudo observacional retrospectivo.

Publisher: Associação de Medicina Intensiva Brasileira Country of Publication: Brazil NLM ID: 9506692 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1982-4335 (Electronic) Linking ISSN: 0103507X NLM ISO Abbreviation: Rev Bras Ter Intensiva Subsets: MEDLINE

Original Publication: [Rio de Janeiro] : Associação de Medicina Intensiva Brasileira

Critical Illness* ; Early Warning Score*; Intensive Care Units/*statistics & numerical data ; Patient Readmission/*statistics & numerical data; Tracheostomy/statistics & numerical data ; Adult ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Patient Discharge ; Prognosis ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index

Objective: To evaluate the hypothesis that the Modified Early Warning Score (MEWS) at the time of intensive care unit discharge is associated with readmission and to identify the MEWS that most reliably predicts intensive care unit readmission within 48 hours of discharge.
Methods: This was a retrospective observational study of the MEWSs of discharged patients from the intensive care unit. We compared the demographics, severity scores, critical illness characteristics, and MEWSs of readmitted and non-readmitted patients, identified factors associated with readmission in a logistic regression model, constructed a Receiver Operating Characteristic (ROC) curve of the MEWS in predicting the probability of readmission, and presented the optimum criterion with the highest sensitivity and specificity.
Results: The readmission rate was 2.6%, and the MEWS was a significant predictor of readmission, along with intensive care unit length of stay > 10 days and tracheostomy. The ROC curve of the MEWS in predicting the readmission probability had an AUC of 0.82, and a MEWS > 6 carried a sensitivity of 0.78 (95%CI 0.66 - 0.9) and specificity of 0.9 (95%CI 0.87 - 0.93).
Conclusion: The MEWS is associated with intensive care unit readmission, and a score > 6 has excellent accuracy as a prognostic predictor.

Implement Sci. 2013 Jun 14;8:67. (PMID: 23767696)
QJM. 2001 Oct;94(10):521-6. (PMID: 11588210)
Yonsei Med J. 2015 Mar;56(2):543-9. (PMID: 25684007)
Rev Bras Ter Intensiva. 2013 Apr-Jun;25(2):99-105. (PMID: 23917974)
J Intensive Care. 2015 Jun 26;3(1):30. (PMID: 26157581)
Crit Care. 2013 Jun 29;17(3):R102. (PMID: 23718698)
Crit Care Med. 2017 Feb;45(2):290-297. (PMID: 27632681)
Crit Care Med. 2013 Jan;41(1):24-33. (PMID: 23128381)
Eur J Anaesthesiol. 2012 Mar;29(3):152-7. (PMID: 22273831)
J Bras Pneumol. 2014 Jan-Feb;40(1):73-6. (PMID: 24626273)
PLoS One. 2015 Nov 23;10(11):e0143127. (PMID: 26600463)
J Crit Care. 2012 Aug;27(4):422.e1-9. (PMID: 22172798)
Intensive Crit Care Nurs. 2014 Jun;30(3):121-37. (PMID: 24308898)
Am J Respir Crit Care Med. 2012 May 1;185(9):955-64. (PMID: 22281829)
Crit Care Med. 2009 Oct;37(10):2753-8. (PMID: 19707139)
BMJ Open. 2017 Dec 3;7(12):e019268. (PMID: 29203508)
Ann Am Thorac Soc. 2018 Jul;15(7):846-853. (PMID: 29787309)
BMC Health Serv Res. 2017 Apr 17;17(1):281. (PMID: 28416016)
J Crit Care. 2018 Feb;43:225-229. (PMID: 28926736)
Am J Respir Crit Care Med. 2011 Dec 15;184(12):1342-9. (PMID: 21908411)
Med Intensiva. 2017 Oct;41(7):411-417. (PMID: 28073594)
Rev Bras Ter Intensiva. 2013 Mar;25(1):32-8. (PMID: 23887757)
Crit Care Med. 2016 Aug;44(8):1553-602. (PMID: 27428118)
Ther Clin Risk Manag. 2019 Feb 25;15:315-322. (PMID: 30880997)
Crit Care Med. 2009 Nov;37(11):2882-7. (PMID: 19866504)
PLoS One. 2012;7(11):e48758. (PMID: 23144958)

Date Created: 20200716 Date Completed: 20210526 Latest Revision: 20210526

20260130

PMC7405753

10.5935/0103-507x.20200047

32667433