Predictive value of the modified Early Warning Score in a Turkish emergency department.
OBJECTIVE
The modified Early Warning Score (mEWS) is a triage instrument that promises to predict patient disposition and clinical outcome in emergency departments (EDs). We investigated whether mEWS can predict death, hospital admission, intensive care unit (ICU) admission, and in-hospital deaths in a Turkish setting.


METHODS
We conducted an ED-based prospective study of 309 patients who presented to an academic medical center. The mEWS was recorded in all patients on ED admission. A mEWS >4 was used to define patients at high-risk for the study outcomes.


RESULTS
Patients categorized as being at high-risk either were admitted to ICU (n=23) or to hospital (n=37) 56.6% of the time, or died in ED (n=16) or in hospital (n=29) 42.4% of the time. Patients categorized as being at low-risk either were admitted to ICU (n=25) or to hospital (n=52) 37.4% of the time, or died in ED (n=1) or in hospital (n=4) 2.5% of the time. In multivariate regression analysis, patients with a mEWS of 5 or more were 1.95 times more likely to be admitted to ICU than those with a score less than 5. Patients with high-risk mEWS were 35 times more likely to die in ED and 14 times more likely to die in hospital than those presenting with a low-risk score.


CONCLUSIONS
We conclude that scores on the mEWS predict ICU admission as well as ICU and in-hospital deaths.
Armagan
Erol
E
Department of Emergency Medicine, Uludag University Medical School, Bursa, Turkey.
Yilmaz
Yusuf
Y
Olmez
Omer Fatih
OF
Simsek
Gozde
G
Gul
Cuma Bulent
CB
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D003422:Critical Care / Q000706:statistics & numerical data; D016529:Emergency Nursing / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D012720:Severity of Illness Index; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014218:Triage / Q000706:statistics & numerical data*; D014421:Turkey