2025Journal of the Formosan Medical AssociationOpen access

Leveraging the Modified Early Warning Score (MEWS) in rapid response teams to predict and prevent ICU readmissions

Hong-Yih Tien, J. Su, Wenying Yu, Pan Mei-li, Ya-Chun Yang, Ying-Jen Chiou, C Chen, C L Wu, Hongmei Chen, Hongmei Chen, Matthew Huei-Ming Ma

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Abstract

PURPOSE: Enhancing ICU Readmission Prediction and Prevention: Integrating the Modified Early Warning Score (MEWS) with Rapid Response Teams. This study evaluates the effectiveness of integrating the Modified Early Warning Score (MEWS) with Rapid Response Teams (RRTs) to predict and prevent ICU readmissions. MATERIALS AND METHODS: A retrospective case-control study was conducted to assess adult ICU patients readmitted within 48 h post-transfer to general wards. The predictive accuracy of MEWS was compared with the APACHE II score, validating its integration with RRT interventions. RESULTS: Among 4,160 ICU patients, 74 (1.8 %) were readmitted within 48 h. Readmitted patients exhibited significantly higher mean MEWS scores (4.4 vs. 2.8, p < 0.001), elevated heart and respiratory rates, lower oxygen saturation, and lower systolic blood pressure. MEWS demonstrated superior predictive ability (AUC 71.6 %) compared to APACHE II (AUC 59.0 %). Implementation of MEWS-integrated RRT interventions reduced ICU readmission rates from 1.26 % to 1.12 %. CONCLUSION: MEWS, when combined with timely RRT interventions, enhances early detection and proactive care, thereby reducing ICU readmissions and optimizing resource allocation in critical care settings.

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PURPOSE: Enhancing ICU Readmission Prediction and Prevention: Integrating the Modified Early Warning Score (MEWS) with Rapid Response Teams. This study evaluates the effectiveness of integrating the Modified Early Warning Score (MEWS) with Rapid Response Teams (RRTs) to predict and prevent ICU readmissions. MATERIALS AND METHODS: A retrospective case-control study was conducted to assess adult ICU patients readmitted within 48 h post-transfer to general wards. The predictive accuracy of MEWS was compared with the APACHE II score, validating its integration with RRT interventions. RESULTS: Among 4,160 ICU patients, 74 (1.8 %) were readmitted within 48 h. Readmitted patients exhibited significantly higher mean MEWS scores (4.4 vs. 2.8, p < 0.001), elevated heart and respiratory rates, lower oxygen saturation, and lower systolic blood pressure. MEWS demonstrated superior predictive ability (AUC 71.6 %) compared to APACHE II (AUC 59.0 %). Implementation of MEWS-integrated RRT interventions reduced ICU readmission rates from 1.26 % to 1.12 %. CONCLUSION: MEWS, when combined with timely RRT interventions, enhances early detection and proactive care, thereby reducing ICU readmissions and optimizing resource allocation in critical care settings.

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Available abstract

PURPOSE: Enhancing ICU Readmission Prediction and Prevention: Integrating the Modified Early Warning Score (MEWS) with Rapid Response Teams. This study evaluates the effectiveness of integrating the Modified Early Warning Score (MEWS) with Rapid Response Teams (RRTs) to predict and prevent ICU readmissions. MATERIALS AND METHODS: A retrospective case-control study was conducted to assess adult ICU patients readmitted within 48 h post-transfer to general wards. The predictive accuracy of MEWS was compared with the APACHE II score, validating its integration with RRT interventions. RESULTS: Among 4,160 ICU patients, 74 (1.8 %) were readmitted within 48 h. Readmitted patients exhibited significantly higher mean MEWS scores (4.4 vs. 2.8, p < 0.001), elevated heart and respiratory rates, lower oxygen saturation, and lower systolic blood pressure. MEWS demonstrated superior predictive ability (AUC 71.6 %) compared to APACHE II (AUC 59.0 %). Implementation of MEWS-integrated RRT interventions reduced ICU readmission rates from 1.26 % to 1.12 %. CONCLUSION: MEWS, when combined with timely RRT interventions, enhances early detection and proactive care, thereby reducing ICU readmissions and optimizing resource allocation in critical care settings.

Key concepts: Mews, Early warning score, Medicine, Psychological intervention, Rapid response team, Emergency medicine, Intensive care medicine, Vital signs

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