The value of modified early warning score in severity assessment and prognosis prediction of heat stroke patients

Abstract

Objective To explore the value of modified early warning score (MEWS) in clinical status assessment and outcome prediction of heat stroke patients. Methods The clinical data of 46 heat stroke patients were collected. According to the severity, the subjects were divided into mild group and severe group; and alternatively, according to the treatment outcomes, the subjects were also divided into survival group and death group. The MEWS at admission was employed for comparison of the differences in severity and outcome of heat stroke between groups. Receiver operating characteristic curve (ROC curve) was used to evaluate the accuracy of MEWS used at admission in assessing severity and predicting outcome of heat stroke patients. Results The results of MEWS calculated at admission in mild and severe heat stroke patients showed significant difference between them (3.00±1.70 vs. 6.85±3.03, P=0.004). The area under the ROC curve (AUC) of MEWS got at admission for the diagnosis of severe heat stroke was 0.864±0.056. The results of MEWS obtained at admission in survived and died heat stroke patients were 5.13±2.96 and 9.25±2.05, respectively (P=0.037). The AUC of MEWS used at admission for predicting the death of heat stroke patients was 0.867±0.061. Conclusions The initial MEWS is useful to accurately assess and predict the outcome of heat stroke patients. Heat stroke patients with higher level of MEWS used at admission than 4.5 could be diagnosed as severe heat stroke, and whereas the value of MEWS got at admission higher than 7.5 could be the indicator of the poor prognosis. Key words: Modified early warning score(MEWS); Heat stroke; Condition assessment; Diagnosis; Death; Prognosis; ROC curve; Feasibility