COMPARISON OF MODIFIED EARLY WARNING SCORE(MEWS) AND APACHE II SCORE IN EVALUATION SEVERITY AND PREDICTION OUTCOME OF EMERGENCY POTENTIAL SEVERITY DISEASE

Objective To compare the applicability and practicability of MEWS and APACHE Ⅱ in evaluating severity and predicting outcome of emergency potential severity disease.Methods Dada of all 501patients in emergency observation ward and rescue room were recorded and scored with MEWS and APACHE Ⅱ score respectively.Main outcome measures were cardiac arrest and CPCR,intensive care unit(ICU) admission,high dependency unit(HDU) admission,outpatient;death,hospital discharge in 30 days.Ratio of patients in deferent score segments for these indexes were compared respectively as well as area under of ROC curve of MEWS and APACHE Ⅱ score in some of these indexes.Results A ScoreMax of 5 or more was associated with an increase risk of death,ICU admission and HDU admission for MEWS.Ratio of severity patients in score of 5 or more was significantly higher than that of score of less to 5(P0.05).The sensitivity was 100% and specificity was 81.5% when 5 of MEWS were used to discriminate the ICU admission of patients;the sensitivity was 84.3% and specificity was 88.3% for HDU admission.A Score Max of 15 or more was associated with an increase risk of death,ICU admission and HDU admission for APACHE Ⅱ score.Ratio of severity patients in score of 15 or more was significantly higher than that of score of less than 15(P0.05).The sensitivity was 89.2% and specificity was 96.3% when 15 of APACHE Ⅱ score were used to discriminate the ICU admission of patients;the sensitivity was 94.3% and specificity was 82.3% for HDU admission at 10 of APACHE Ⅱ score.In discriminating the ICU admission and death risk of patients,MEWS had considerable power compared with APACHE Ⅱ score(P0.05).All of MEWS and APACHE Ⅱ had good discriminating power for ICU admission and death risk of patients.APACHE Ⅱ had better power in discriminating HDU admission compared with MEWS(P0.05).Conclusion All of MEWS and APACHE Ⅱ can be used to evaluate severity of emergency patients and discriminate the emergency potential severity patients.MEWS may be the first one because of speediness,simplicity,less of spending and handiness compared with APACHE Ⅱ.