title: The value of the Modified Early Warning Score and biochemical parameters as predictors of patient outcome in acute medical admissions a prospective study.
abstract: We evaluated the effectiveness of MEWS and biochemical parameters in predicting outcomes for acute medical admissions. Data from consecutive admissions to the Acute Medical Unit (AMU) of National Hospital of Sri Lanka were collected. C-reactive protein (CRP), albumin, white cell count, platelet count and haemoglobin values were collected. Adverse endpoints were HDU/ICU admission,cardio-respiratory emergency/resuscitation and death. A MEWS score of >=5 together with increasing age,pulse rate, respiratory rate, AVPU score, CRP,CRP/Albumin ratio and reduced platelet and albumin levelall increased the odds of reaching "adverse endpoints". Adding a score for biochemical parameters increased the area under the ROC curve for reaching "adverse endpoints" Biochemical parameters better predicted length of hospital stay and adverse outcomes. A combined scoring system improved the sensitivity of prediction.
authors: Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka. yashas2004@yahoo.com
authors: Yashasvi Sanja
authors: YS
authors: Perera
authors: Priyanga
authors: P
authors: Ranasinghe
authors: Adikari Mudiyanselage Madura Chinthana
authors: AM
authors: Adikari
authors: Welivitage Don Thilina Sampath
authors: WD
authors: Welivita
authors: Wickramage Malith Eranda
authors: WM
authors: Perera
authors: Wijesundara Mudiyanselage Dileepa Roshan
authors: WM
authors: Wijesundara
authors: Sembukutti Arachchige Ajith Panduka
authors: SA
authors: Karunanayake
authors: Godwin Roger
authors: GR
authors: Constantine
mesh_terms: D000208:Acute Disease / Q000145:classification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D005260:Female; D006339:Heart Rate; D006454:Hemoglobins / Q000032:analysis*; D006760:Hospitalization; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010976:Platelet Count; D019095:Point-of-Care Systems; D012372:ROC Curve; D056152:Respiratory Rate; D012709:Serum Albumin / Q000032:analysis*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D012709:Serum Albumin; D002097:C-Reactive Protein