Comparison of within 7 Day All-Cause Mortality among HDU Patients with Modified Early Warning Score of ≥5 with those with Score of <5

Majid Ahmed Shaikh; Avinash Punshi; Mohan Lal Talreja; Tazeen Rasheed; Nimrah Bader; Bader Faiyaz Zuberi

doi:10.12669/pjms.37.2.2832

Comparison of within 7 Day All-Cause Mortality among HDU Patients with Modified Early Warning Score of ≥5 with those with Score of <5

Pak J Med Sci. 2021 Mar-Apr;37(2):515-519. doi: 10.12669/pjms.37.2.2832.

Authors

Majid Ahmed Shaikh¹, Avinash Punshi², Mohan Lal Talreja³, Tazeen Rasheed⁴, Nimrah Bader⁵, Bader Faiyaz Zuberi⁶

Affiliations

¹ Majid Ahmed Shaikh, FCPS, Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
² Avinash Punshi, FCPS, Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
³ Mohan Lal Talreja, MRCP, Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
⁴ Tazeen Rasheed, FCPS, Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
⁵ Nimrah Bader, Department of Internal Medicine University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
⁶ Bader Faiyaz Zuberi, FCPS, Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

Abstract

Objective: To compare 7-Day All-Cause Mortality among HDU Patients with Modified Early Warning Score of ≥5 with Those with Score of <5.

Methods: All patients of age more than 18 years, of either gender admitted in HDU of Medical Unit-II, CHK between September 2019 to February 2020 were included. MEWS was calculated for each patient at time of admission. Patients with MEWS score of ≥5 were allocated to Group-A and those with score of <5 were allocated to Group-B. Patients were followed for seven days and outcome status of alive, expired or discharged was noted.

Results: Total of 336 patients were selected out of which 168 patients was inducted in Group-A and 168 patients in Group-B. MEWS Score in patients who expired was significantly higher (Mdn=11) than in those who survived (Mdn=4), p <.001. 7-day mortality in Group-A was 62 (39.9%) while in Group-B was 40 (23.8%). ROC was plotted of MEWS Score for mortality, it showed significant area under curve of 68.4% (p <.001, 95% CI = .62 to .75). MEWS Score of 3.5 showed sensitivity of 89.2% and specificity of 65%.

Conclusion: Our results show that MEWS has a positive trend to predict mortality. MEWS score of 3.5 is suggested cut off based on ROC in our study.

Keywords: MEWS Score; Mortality; ROC.