Predictive value of modified early warning score for closed abdominal trauma

Abstract

Objective To observe the clinical effect of modified early warning score (MEWS) in evaluating closed abdominal trauma. Methods From January 2008 to November 2017, one hundred and sixty patients with closed abdominal trauma admitted to the Fifth People’s Hospital of Wuhu were enrolled. Clinical diagnosis and prognosis data were retrospectively analyzed. The MEWS system was used to evaluate the patients’ diagnosis (outpatient or specialist conservative treatment, ICU rescue, transfer operation), complications in the course of treatment and 30 days’ prognosis. Results Among the 160 patients, 64 cases (40.0%) were treated conservatively, 96 (60.0%) were admitted to ICU, and 34 (21.3%) underwent transfer operation. There were 16 cases with MEWS score >8. The rate of conservative treatment was significantly lower than that of other scores (except of MEWS score >6-8). The rate of rescue in ICU (100.0%) was significantly higher than that in other segments (except of MEWS score >6-8). The conversion rate was significantly lower than the MEWS score <3 and 3-4 segments. The prognosis in 30 d was good in 124 cases (77.5%), the MEWS score was (2.44±1.32), 36 (22.5%) with poor prognosis, and the MEWS score was 6.84±2.12. Twelve cases (7.5%) died, 16 (10.0%) were infected, 4 (2.5%) had multiple organ failure, and 4 cases (2.5%) suffered from stress ulcer. The ROC curve analysis showed that the MEWS score had a certain predictive value for poor prognosis in patients with closed abdominal trauma. Area under the curve was 0.919 (P<0.001, 95% CI=0.797-1.000), the cut-off value was 5.970, the sensitivity was 0.667, and the specificity was 0.986. Conclusion MEWS plays an important role in choosing triage protocols and evaluating prognosis of closed abdominal trauma, reducing complications and mortality, and improving the prognosis. Key words: Abdominal injuries; MEWS score; ROC curve; Forecasting