title: [Validation of a modified early warning score to predict ICU transfer for patients with severe sepsis or septic shock on general wards].
abstract: OBJECTIVE
  To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards.
  
  
  METHODS
  A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program.
  
  
  RESULTS
  Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer.
  
  
  CONCLUSIONS
  MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.
authors.affiliation: Medical Alert Team, Asan Medical Center, Seoul, Korea.
authors.forename: Ju Ry
authors.initials: JR
authors.lastname: Lee
authors.affiliation: College of Medicine, University of Ulsan, Seoul, Korea. reniechoi@hanmail.net.
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Choi
mesh_terms: D018806:APACHE; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000032:analysis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010362:Patients' Rooms; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D018805:Sepsis / Q000473:pathology*; D012772:Shock, Septic / Q000473:pathology*
chemical_list: D019344:Lactic Acid
keywords: Hospital rapid response team; Intensive care unit; Modified early warning score; Sepsis; Septic shock