title: Correlation of the predictive ability of early warning metrics and mortality for cardiac arrest patients receiving in-hospital Advanced Cardiovascular Life Support.
abstract: BACKGROUND
  The Modified Early Warning Score (MEWS) helps identify patients experiencing a decline in physiological parameters that indicate risk for cardiac arrest (CA).
  
  
  OBJECTIVE
  To assess the association between MEWS values and patient survival following in-hospital CA.
  
  
  METHODS
  Retrospective cohort study of patients who experienced in-hospital CA. The relationship between CA survival and MEWS values as well as other risk factors such as age, gender and type of electrographic cardiac rhythms was analyzed using logistic regression.
  
  
  RESULTS
  Survival rate to hospital discharge was 21%. Strong predictors for survival were MEWS values at hospital admission (p < .002), younger age (p < .005), ventricular fibrillation (p < .0001), and ventricular tachycardia (p < .0001). Gender and MEWS 4 hours prior to CA were not significantly associated with survival.
  
  
  CONCLUSIONS
  Survival following CA was significantly associated with MEWS at hospital admission but not 4 hours prior to CA. The type of cardiac rhythm and age were also predictive of survival.
authors.affiliation: Interprofessional Education Hofstra-Northwell Health, School of Graduate Nursing and Physician Assistant Studies, Science Education, Hofstra Northwell Health School of Medicine, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: DeVoe
authors.affiliation: Department of Allergy & Immunology, Northwell Health, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Roth
authors.affiliation: Cardiothoracic Surgery, Northwell Health, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Maurer
authors.affiliation: Research Health Outcomes, Patient Safety Institute, Center for Learning and Innovation, Northwell Health, USA.
authors.forename: Michal
authors.initials: M
authors.lastname: Tamuz
authors.affiliation: Biostatistics Unit, The Feinstein Institute for Medical Research, Northwell Health, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Lesser
authors.affiliation: Department of Medicine, Hofstra Northwell Health School of Medicine, USA; Department of Occupational Medicine Epidemiology and Prevention, Hofstra Northwell Health School of Medicine, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Pekmezaris
authors.affiliation: Department of Cardiology, Nassau University Medical Center, USA; Department of Cardiology, Hofstra Northwell School of Medicine, USA.
authors.forename: Amgad N
authors.initials: AN
authors.lastname: Makaryus
authors.affiliation: Cardiothoracic Services, Northwell Health, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Hartman
authors.affiliation: Department of Medicine, Hofstra Northwell Health School of Medicine, USA; Department of Occupational Medicine Epidemiology and Prevention, Hofstra Northwell Health School of Medicine, USA. Electronic address: pdimarzi@nshs.edu.
authors.forename: Paola
authors.initials: P
authors.lastname: DiMarzio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008020:Life Support Care / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D014218:Triage / Q000379:methods*; D014481:United States / Q000453:epidemiology; D014693:Ventricular Fibrillation / Q000150:complications* / Q000628:therapy; D055815:Young Adult
keywords: Advanced cardiovascular life support; Cardiac arrest; Cardiac rhythm; MEWS; Survival