AI Article Synopsis
- The study investigates the effectiveness of the National Early Warning Score (NEWS) and Rapid Emergency Medicine Score (REMS) in predicting the prognosis of patients treated by a medical emergency team, in comparison to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score.
- Conducted as a retrospective cohort study from April 2013 to March 2019, it found that while all three scoring systems were associated with 28-day mortality, NEWS exhibited greater sensitivity than REMS.
- Although NEWS performed better than REMS and can be considered a valid screening tool, it still lacks the accuracy of APACHE II, prompting the need for a better tool that is easy to use at the bedside.
Article Abstract
Introduction: The medical emergency team enables the limitation of patients' progression to critical illness in the general ward. The early warning scoring system (EWS) is one of the criteria for medical emergency team activation; however, it is not a valid criterion to predict the prognosis of patients with MET activation.
Aim: In this study, the National Early Warning Score (NEWS) and Rapid Emergency Medicine Score (REMS) was compared with that of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting the prognosis of patients who had been treated a medical emergency team.
Material And Methods: In this single-centre retrospective cohort study, patients treated by a medical emergency team between April 2013 and March 2019 and the 28-day prognosis of MET-activated patients were assessed using APACHE II, NEWS, and REMS.
Results: Of the 196 patients enrolled, 152 (77.5%) were men, and 44 (22.5%) were women. Their median age was 68 years (interquartile range: 57-76 years). The most common cause of medical emergency team activation was respiratory failure (43.4%). Univariate analysis showed that APACHE II score, NEWS, and REMS were associated with 28-day prognostic mortality. There was no significant difference in the area under the receiver operating characteristic curve of APACHE II (0.76), NEWS (0.67), and REMS (0.70); however, the sensitivity of NEWS (0.70) was superior to that of REMS (0.47).
Conclusion: NEWS is a more sensitive screening tool like APACHE II than REMS for predicting the prognosis of patients with medical emergency team activation. However, because the accuracy of NEWS was not sufficient compared with that of APACHE II score, it is necessary to develop a screening tool with higher sensitivity and accuracy that can be easily calculated at the bedside in the general ward.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647673 | PMC |
| http://dx.doi.org/10.2478/jccm-2021-0040 | DOI Listing |
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