Application value of MEWS and corrected MEWS in predicting where postoperative patients of General Surgery Department will go

Abstract

Objective To explore the application value of Modified Early Waring Score (MEWS) and corrected MEWS in predicting where postoperative patients of General Surgery Department will go. Methods From January 2017 to December 2018, a total of 1 160 postoperative patients of General Surgery Department at Shanghai Pudong New Area Gongli Hospital were selected by convenience sampling. Data of patients were selected including the vital signs of patients within 72 hours after transferring to wards, consciousness, oxygen saturation and urine volume. Patients were evaluated with the MEWS and the corrected MEWS respectively. This study calculated the highest scores of those two tools and observed that where patients would go. This study also compared the sensitivity, specificity, positive predictive value (PPV) , negative predictive value (NPV) and receiver operating characteristic (ROC) curve of resolution which predicted where patients would go between the two scores. Results The scores of corrected MEWS of patients transferring to Intensive Care Unit (ICU) were higher than those of MEWS. When taking being admitted to ICU as the predicted target, area under ROC curve of MEWS was 0.986 (95%CI: 0.973-0.998) and the best cutoff value was 3 with 0.903 for the maximum Youden index at this moment; area under ROC curve of corrected MEWS was 0.991 (95%CI: 0.978-0.995) and the best cutoff value was 5 with 0.943 for the maximum Youden index at this moment. The area under ROC curve of corrected MEWS was greater than that of MEWS with a statistical difference (P 0.05) . Conclusions Compared with MEWS, the corrected MEWS could reflect condition severity of postoperative patients of General Surgery Department better and correctly predict patient's conditions which is worthy of being popularized and applied in General Surgery. Key words: ROC curve; Modified early waring score; Corrected modified early waring score; General surgery; Postoperative