The prognastic efficiencies of modified early warning score and mainz emergency evaluation score for emergency department patients

Abstract

Background: Recently, there is an increasing interest for scoring systems to evaluate the critically ill patients by means of the severeness of their disease and their availibility for discharge in the emergency departments and intensive care units. Our aim in this study is to evaluate the efficiency of the mEWS and MEES scoring systems in assessing the severeness of the disease and predicting the mid term prognosis of the patients hospitalized following their emergency care in our emergency room.

Material and Method: Patients, who attended to Inonu University Department of Emergency Medicine and hospitalized following their emergency care were included to our study. The effects of age, sex, triage categories, mEWS and MEES scores on the site of hospitalization and mortality was evaluated. Statistical analyses were performed by SPSS for Windows version 16.0. The data was summarized as means, standart deviation and percents. Univariate and multiavriate analyses were performed for risk factor calculations.

Results: The mean age of the patients was 58±19 and 584 (56%) were male. Triage group 1 patients accounted for 21 of all (2%), while 646 (61%) were in group 2 and 384 (37%) were in triage group 3. Of all patients, 341 (32%) were hospitalized to ICU. While discharged patients accounted for 89% (935 patients) of the study group, 116 patients (11%) died at the hospital. The GCS, AVPU and mEWS values were statistically significant by means of patient mortality (P < 0.0001), but the delta MEES value was not (P < 0.127).

Conclusion: The results of our stuy suggests that mEWS evaluation is an effective and reliable tool for predicting outcome and hospitalization areas of ED patients. Our results also displayed that the easily available GCS and AVPU scales are reliable guides in patient management. MEES values, on the other hand, are not convenient for ED use.

Keywords: AVPU, critical patient, emergency department, Glasgow Coma Scale, mainz emergency evaluation scoring, Modified Early Warning Score, prognosis