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验证土耳其版改良早期预警评分系统(MEOWS)图表。

Validation of the Turkish version of the Modified Early Obstetric Warning System (MEOWS) chart.

机构信息

Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun-Türkiye.

Department of Anesthesiology and Reanimation, Bezmialem Vakıf University, Medical School, İstanbul-Türkiye.

出版信息

Ulus Travma Acil Cerrahi Derg. 2024 Sep;30(9):635-643. doi: 10.14744/tjtes.2024.87099.

Abstract

BACKGROUND

The Modified Early Obstetric Warning System (MEOWS) is a score-based or color-coded system that detects changes in physiological parameters and enables earlier diagnosis and care of worsening obstetric patients. The aim of this study is to evaluate the tool's performance and contribute to its use in Türkiye by translating MEOWS into Turkish.

METHODS

This prospective and descriptive study, approved by the local ethics committee, included 350 obstetric in-patients who gave birth at Samsun Training and Research Hospital, Gynecology and Children's Hospital between April and August 2022. The study involved patients with a gestational week greater than 28 weeks and up to six weeks postpartum.

RESULTS

The average age of the patients was 28.9±5.9 (18-40) years, with trigger values occurring in 34.6% (n=121) and morbidity occurring in 30.9% (n=108) of the cases. The most common trigger among the individual physiological indicators was high systolic blood pressure (28.3%). When the performance of MEOWS was evaluated, a statistically significant correlation was found between trigger and morbidity (Kappa=0.605; p<0.001). The sensitivity of MEOWS in estimating morbidity was 77.78% (95% confidence interval [CI]: 68.76-85.21%), specificity was 84.71% (95% CI: 79.55-89.00%), Positive Predictive Value (PPV) was 69.42% (95% CI: 62.40-75.64%), Negative Predictive Value (NPV) was 89.52% (95% CI: 85.67-92.43%), and accuracy was 82.57% (95% CI: 78.18-86.40%).

CONCLUSION

MEOWS was found to be an effective screening tool for predicting morbidity in this study and performs well in Turkish with sufficient sensitivity, specificity, and accuracy. However, the inclusion of long-term results would provide a more comprehensive understanding of the effectiveness of MEOWS.

摘要

背景

改良早期预警评分系统(MEOWS)是一种基于评分或颜色编码的系统,可检测生理参数的变化,从而更早地诊断和治疗病情恶化的产科患者。本研究旨在评估该工具的性能,并通过将 MEOWS 翻译为土耳其语,为其在土耳其的使用做出贡献。

方法

这是一项前瞻性描述性研究,经当地伦理委员会批准,纳入了 2022 年 4 月至 8 月在萨姆松培训与研究医院妇产科和儿童医院分娩的 350 名产科住院患者。研究对象为孕龄大于 28 周且产后 6 周内的患者。

结果

患者的平均年龄为 28.9±5.9(18-40)岁,触发值发生率为 34.6%(n=121),发病率为 30.9%(n=108)。个体生理指标中最常见的触发因素是收缩压升高(28.3%)。当评估 MEOWS 的性能时,发现触发值与发病率之间存在统计学显著相关性(Kappa=0.605;p<0.001)。MEOWS 估计发病率的敏感性为 77.78%(95%置信区间 [CI]:68.76-85.21%),特异性为 84.71%(95% CI:79.55-89.00%),阳性预测值(PPV)为 69.42%(95% CI:62.40-75.64%),阴性预测值(NPV)为 89.52%(95% CI:85.67-92.43%),准确性为 82.57%(95% CI:78.18-86.40%)。

结论

本研究发现 MEOWS 是一种预测发病率的有效筛查工具,在土耳其具有足够的敏感性、特异性和准确性。然而,纳入长期结果将更全面地了解 MEOWS 的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f03/11622726/bef6f40d9f7a/TJTES-30-635-g001.jpg

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