Degree of illness of a patient.
Measured Factor Detail
The MEWS can be used for all hospitalized patients to carry out the early detection of clinical deterioration and need for higher level of care.
Multiple body systems
Measured Factor Low Impact
- A score of 3 and 4 shows 12.7% chance of ICU admission or death within 60 days
- A score of 0,1 and 2 shows 7.9% chance of ICU admission or death within 60 days
Measured Factor High Impact
- A score ≥5 is statistically linked to increased likelihood of death or admission to an intensive care unit with 30% chance
MEWS score is flawed with respect to that it has a medical bias. Trauma patients may have severe injuries and yet have a low MEWS score if they have stable physiology and MEWS doesnt include any mobility factor.
Study Validation 1
The aim of the study was to validate the modified Early Warning Score (MEWS) in identifying the medical patients who are at risk of catastrophic deterioration. Retrospective data was collected from 709 medical emergency admissions. The primary outcomes measured were death, intensive care unit (ICU) admission, high dependency unit (HDU) admission, cardiac arrest, survival and hospital discharge at 60 days. MEWS score was assigned to patients and score of 5 or greater were associated with high risk of death, ICU admissions and HDU admission. This study concluded that MESWS is a clinically effective tool in scrutinizing the a patients who are at risk of getting catastrophic deterioration in a busy clinic.
Study Validation 2
The aim of this a prospective study was to determine the performance of MEWS to characterize patients at risk of catastrophic deterioration in a busy ward. From 427 emergency cases data was collected. The primary outcomes measured were death, intensive care unit (ICU) admission and inpatient hospital admission. Results showed that when MEWS Scores was > 4 it was associated with augmented risk of death, admissions to ICU and hospitals. This study concluded that MEWS score is strong and decisive tool to identify the patients at risk of deterioration in a busy ward thus required special attention and care.
Study Validation 3
This study was conducted with the aim to prevent delay in starting a intervention or shifting of critically ill patients. 334 consecutive clinic patients were recruited in the study. MEWS score were evaluated in all patients. Results showed that 57 patients scored four or more on MEWS and need to shift to ICU while 16 patients were to be admitted at ITu. MEWS score was 75% sensitive and specificity was 83%. This study concluded that call out addition of call out algorithm to MEWS score can increased its credibility.
Study Additional 1
The aim of this retrospective study was to determine the effectiveness of MEWS in oncology patients. Data was collected from 840 patients and evaluated. MEWS score was assigned to patients and prediction of Critical Care admission and 30 day mortality was evaluated. Results showed that MEWS score was significant in assessing the both outcomes (CCU admission P = 0.037 and 30 day mortality P = 0.004). Analysis of receiver operator curves displayed a poor MEWS value in predicting the outcomes. This study concluded that current score had poor predictive value and needs more improvement in predicting risk of deterioration in oncology patients.
Study Additional 3
The aim of the study was to determine MEWS as a predictor of death and to find out any additional variable for mortality. A total of 452 patients were selected in the study and MEWS was calculated up to 7 days. Vital and demographic signs were evaluated. Results showed higher MEWS score indicated towards hemodynamic instability. In-hospital mortality at 7-days was 5.5% while 41.4% of subjects were discharged and 53.1% were kept in the ward. This study concludes that MEWS can be important and adequate tool in identifying patients at higher risk of death.