Efficiency of Early Warning Scores for Predicting the Likelihood of Intubation or Cardiopulmonary Resuscitation in Patients of General Medical Wards
Early Warning Scores for Predicting the Likelihood of Intubation or Cardiopulmonary Resuscitation
Keywords:
intubation, cardiopulmonary resuscitation, early waning scoreAbstract
High mortality rates are associated with in cidence of intubation or cardiopulmonary resuscitation. Changes in vital signs are typically observed prior to these incidents, and Early Warning Scores (EWS) are used to identify patients who are deteriorating. This retrospective study was performed from medical records to compare the efficiency of three EWS models (National Early Warning Score, Modified Early Warning Score, and Search Out Sepsis Score) in predicting incidents of intubation or cardiopulmonary resuscitation in 120 patients undergoing endotracheal intubation or resuscitation in a general internal medicine ward and 120 randomly assigned patients without incident. It was found that the sensitivity, specificity and efficiency (Youden Index) were highest at four hours before the incident as follows: The National Early Warning Score had the highest sensitivity, specificity and Youden Index (0.871, 0.775, 0.682), followed by the Modified Early Warning Score (0.843, 0.783, 0.681) and Search Out Sepsis Score (0.643, 0.892, 0.535) respectively. However, when patients were intubated or received cardiopulmonary resuscitation, it was found that mortality, transfer, rejection of treatment and longer hospital stays was significantly higher than non- incident group. Thus, the efficiency, sensitivity, and specificity of tools decreased with time away from the incidence.
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