Consultant Anaesthetist, Barnet Hospital, Herts, UK.
Consultant Anaesthetist, Royal Free Hospital, London, UK.
Anaesthesia. 2012 Jan;67(1):12-18. doi: 10.1111/j.1365-2044.2011.06896.x. Epub 2011 Nov 9.
The 2003-2005 Confidential Enquiry into Maternal and Child Health report recommended the introduction of the modified early obstetric warning system (MEOWS) in all obstetric inpatients to track maternal physiological parameters, and to aid early recognition and treatment of the acutely unwell parturient. We prospectively reviewed 676 consecutive obstetric admissions, looking at their completed MEOWS charts for triggers and their notes for evidence of morbidity. Two hundred patients (30%) triggered and 86 patients (13%) had morbidity according to our criteria, including haemorrhage (43%), hypertensive disease of pregnancy (31%) and suspected infection (20%). The MEOWS was 89% sensitive (95% CI 81-95%), 79% specific (95% CI 76-82%), with a positive predictive value 39% (95% CI 32-46%) and a negative predictive value of 98% (95% CI 96-99%). There were no admissions to the intensive care unit, cardio respiratory arrests or deaths during the study period. This study suggests that MEOWS is a useful bedside tool for predicting morbidity. Adjustment of the trigger parameters may improve positive predictive value.
2003-2005 年母婴健康保密调查建议在所有产科住院患者中引入改良早期预警评分系统（MEOWS），以跟踪产妇的生理参数，并帮助早期识别和治疗急性不适的产妇。我们前瞻性地回顾了 676 例连续产科入院患者，查看了他们完成的 MEOWS 图表中的触发因素及其病历中是否存在发病证据。根据我们的标准，有 200 名患者（30%）触发了 MEOWS，86 名患者（13%）出现了发病，包括出血（43%）、妊娠高血压疾病（31%）和疑似感染（20%）。MEOWS 的敏感性为 89%（95%CI 81-95%），特异性为 79%（95%CI 76-82%），阳性预测值为 39%（95%CI 32-46%），阴性预测值为 98%（95%CI 96-99%）。在研究期间，没有患者入住重症监护病房、心肺骤停或死亡。这项研究表明，MEOWS 是一种预测发病率的有用床边工具。调整触发参数可能会提高阳性预测值。
