Ogbebor Osakpolor, Niranjan Sitara, Saini Vikram, Ramanujam Deeksha, DiSilvio Briana, Cheema Tariq
Department of Pulmonary and Critical Care Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA.
Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA.
J Clin Med. 2025 Jul 30;14(15):5384. doi: 10.3390/jcm14155384.
: In-hospital cardiac arrest has high incidence and poor survival rates, posing a significant healthcare challenge. It is important to intervene in the hours before the cardiac arrest to prevent poor outcomes. The modified early warning score (MEWS) is a validated tool for identifying a deteriorating patient. It is an aggregate of vital signs and level of consciousness. We retrospectively evaluated MEWS for trends that might predict patient outcomes. : We performed a single-center, one-year, retrospective study. A comprehensive review was conducted for patients aged 18 years and above who experienced a cardiac arrest. Cases that occurred within an intensive care unit, emergency department, during a procedure, or outside the hospital were excluded. A total of 87 cases met our predefined inclusion criteria. We collected data at 12 h, 6 h and 1 h time periods prior to the cardiac arrest. A trend analysis using a linear model with analysis of variance with Bonferroni correction was performed. : Out of 87 patients included in the study, 59 (67.8%) had an immediate return of spontaneous circulation (ROSC). Among those who achieved ROSC, 41 (69.5%) died during the admission. Only 20.7% of the patients that sustained a cardiac arrest survived to discharge. A significant increase in the average MEWS was noted from the 12 h period (MEWS = 3.95 ± 2.4) to the 1 h period (MEWS = 5.98 ± 3.5) ( ≤ 0.001) and the 6 h period (4.65 ± 2.6) to the 1 h period (5.98 ± 3.5) ( = 0.023) prior to cardiac arrest. : An increase in the MEWS may be a valuable tool in identifying at-risk patients and provides an opportunity to intervene at least 6 h before a cardiac arrest event. Further research is needed to validate the results of our study.
院内心脏骤停发病率高且生存率低，这对医疗保健构成了重大挑战。在心脏骤停前数小时进行干预以防止不良后果非常重要。改良早期预警评分（MEWS）是一种经过验证的用于识别病情恶化患者的工具。它是生命体征和意识水平的综合指标。我们回顾性评估了MEWS以寻找可能预测患者预后的趋势。
我们进行了一项单中心、为期一年的回顾性研究。对18岁及以上经历心脏骤停的患者进行了全面审查。排除在重症监护病房、急诊科、手术过程中或院外发生的病例。共有87例符合我们预先定义的纳入标准。我们在心脏骤停前12小时、6小时和1小时时间段收集数据。使用带有Bonferroni校正的方差分析的线性模型进行趋势分析。
在纳入研究的87例患者中，59例（67.8%）立即恢复自主循环（ROSC）。在实现ROSC的患者中，41例（69.5%）在住院期间死亡。心脏骤停患者中只有20.7%存活至出院。在心脏骤停前，平均MEWS从12小时时间段（MEWS = 3.95±2.4）到1小时时间段（MEWS = 5.98±3.5）有显著增加（≤0.001），从6小时时间段（4.65±2.6）到1小时时间段（5.98±3.5）也有显著增加（= 0.023）。
MEWS升高可能是识别高危患者的有价值工具，并为在心脏骤停事件前至少6小时进行干预提供了机会。需要进一步研究来验证我们的研究结果。
