1. Evaluation of the threshold value for the modified early warning score (MEWS) in medical septic patients: a secondary analysis of an Italian multicentric prospective cohort (SNOOPII study)
- Author
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Francesco Dentali, M. La Regina, A. Lo Gullo, Maurizia Gambacorta, Tiziana Attardo, A. Mazzone, Daniela Tirotta, F. Panzone, and Mauro Campanini
- Subjects
Male ,Patient Transfer ,medicine.medical_specialty ,Population ,030204 cardiovascular system & hematology ,Sensitivity and Specificity ,Severity of Illness Index ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,law ,Sepsis ,Chi-square test ,medicine ,Humans ,Hospital Mortality ,Prospective Studies ,030212 general & internal medicine ,education ,Intensive care medicine ,Prospective cohort study ,Aged ,education.field_of_study ,business.industry ,Medicine (all) ,Secondary data ,General Medicine ,Middle Aged ,Prognosis ,Early warning score ,medicine.disease ,Intensive care unit ,Comorbidity ,Hospitalization ,Mews ,Intensive Care Units ,Italy ,ROC Curve ,Emergency medicine ,Female ,business - Abstract
Background: Due to aging and resources limitation, septic patients are often admitted to medical wards (MWs). Early warning deterioration is a relevant issue in this setting. Unfortunately, a suitable prognostic score has not been identified, yet. Aim: To explore the ability of Modified Early Warning Score (MEWS) to predict the in-hospital mortality in septic patients admitted to MWs. Design: secondary analysis of a multicentric prospective study Methods: Consecutive septic patients with positive blood culture admitted to 31 Italian MWs were included. Baseline characteristics, clinics, isolates, rate of transfer to ICU, MEWS was collected on admission according to the study protocol. The accuracy of MEWS in predicting the in-hospital mortality was assessed with the area under the receiver-operating characteristic (ROC) curves (AUC). Sensitivity, specificity, positive and negative predictive value (PPV and NPV), likelihood ratio (LR) were calculated for different MEWS cut-offs and age/comorbidities subgroups. Results: 526 patients were included in this analysis. Median MEWS was (range 0 to 11). In-hospital mortality was 14.8% and transfer to ICU 1.3%. Mortality progressively increased according to MEWS (3% in MEWS 0 vs 27% in MEWS >5; Chi square for trend p
- Published
- 2017
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