Dundar Zerrin Defne, Ergin Mehmet, Karamercan Mehmet A, Ayranci Kursat, Colak Tamer, Tuncar Alpay, Cander Basar, Gul Mehmet
aEmergency Medicine Department, Meram Faculty of Medicine, Necmettin Erbakan University, Konya bEmergency Medicine Department, Faculty of Medicine, Gazi University, Ankara, Turkey.
Eur J Emerg Med. 2016 Dec;23(6):406-412. doi: 10.1097/MEJ.0000000000000274.
The aim of this study was to evaluate the value of the Modified Early Warning Score (MEWS) and the VitalPac Early Warning Score (VIEWS) in predicting hospitalization and in-hospital mortality in geriatric emergency department (ED) patients.
This prospective, single-centered observational study was carried out over 1 month at the ED of a university hospital in patients 65 years of age and older presenting to the ED. The vital parameters of the patients measured on admission to ED were recorded. The MEWS and VIEWS were calculated using the recorded physiological parameters of the patients. Hospitalization and in-hospital mortality were used as the primary outcomes.
A total of 671 patients included in the study. The median age of the patients was 75 (11) years, and 375 (55.9%) were men. The MEWS is effective for discriminating patient groups that have been discharged from ED, admitted to a ward and admitted to ICU [1 (2) vs. 1 (1) vs. 3 (3), respectively, P<0.001]. The VIEWS is also effective for discriminating patient groups that have been discharged from ED, admitted to a ward, and admitted to ICU [2 (3) vs. 5 (5) vs. 8 (8), respectively, P<0.001]. The AUCs of the MEWS and VIEWS were 0.727 [95% confidence interval (CI) 0.689-0.765] and 0.756 (95% CI 0.720-0.792) in predicting hospitalization, respectively. The AUCs of the MEWS and VIEWS were 0.891 (95% CI 0.844-0.937) and 0.900 (95% CI 0.860-0.941) in predicting in-hospital mortality, respectively.
The MEWS and VIEWS are powerful scoring systems that are easy-to-use for predicting the hospitalization and in-hospital mortality of geriatric ED patients.
本研究旨在评估改良早期预警评分（MEWS）和生命体征早期预警评分（VIEWS）在预测老年急诊科（ED）患者住院情况及院内死亡率方面的价值。
这项前瞻性、单中心观察性研究在一家大学医院的急诊科进行，为期1个月，纳入65岁及以上就诊于该急诊科的患者。记录患者急诊入院时测量的生命体征参数。根据记录的患者生理参数计算MEWS和VIEWS。将住院情况和院内死亡率作为主要结局指标。
本研究共纳入671例患者。患者的中位年龄为75（11）岁，男性375例（55.9%）。MEWS对于区分已从急诊科出院、入住病房和入住重症监护病房的患者群体有效[分别为1（2）vs. 1（1）vs. 3（3），P<0.001]。VIEWS对于区分已从急诊科出院、入住病房和入住重症监护病房的患者群体也有效[分别为2（3）vs. 5（5）vs. 8（8），P<0.001]。MEWS和VIEWS在预测住院情况方面的曲线下面积（AUC）分别为0.727[95%置信区间（CI）0.689 - 0.765]和0.756（95% CI 0.720 - 0.792）。MEWS和VIEWS在预测院内死亡率方面的AUC分别为0.891（95% CI 0.844 - 0.937）和0.900（95% CI 0.860 - 0.941）。
MEWS和VIEWS是强大的评分系统，易于用于预测老年急诊患者的住院情况及院内死亡率。
