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Validation of a modified Early Warning Score in medical admissions

Validation of a modified Early Warning Score in medical admissions,10.1093/qjmed/94.10.521,C. P. Subbe,M Kruger,P Rutherford,L Gemmel

Validation of a modified Early Warning Score in medical admissions   (Citations: 125)
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Published in 2001.
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    • ... Quality of Life (Euroqol EQ5D [16])  Prior and current physical disability (Barthel index [17])  Behavioural and psychological symptoms (Neuropsychiatric Inventory [18])  Medical diagnoses  Drugs taken on admission  Illness severity (Modified Early Warning Score [19])  Hospital admission in the previous year  Carer relationship, co-residence and amount of care given  Carer strain index [20]  Carer psychological distress (GHQ-12 ...

    Rowan H Harwoodet al. Evaluation of a Medical and Mental Health Unit compared with standard ...

    • ...Recognizing the need for improving acute pancreatitis scoring systems’ ability to predict adverse outcomes, we studied whether NLR is superior to WBC in the prediction of adverse outcomes. In our literature search, we found no previous study that investigated the value of NLR as a predictor of adverse outcomes in acute pancreatitis.MethodsThis observational study explored the value of NLR as a predictor of defined adverse outcomes among 339 patients admitted to a tertiary care center between January 2005 and January 2008 with a diagnosis of acute pancreatitis. The study inclusion criteria required the clinical diagnosis of acute pancreatitis with an elevated serum amylase and lipase and/or positive CT scan findings of acute pancreatitis. The exclusion criteria included any of the following: age greater than 80 years, a diagnosis of cancer or hematological proliferative disease under treatment, current steroid or chemotherapy for any reason, normal findings on amylase and lipase testing and failure of finding changes of pancreatitis on CT examination, and unavailable complete blood counts or medical records (fig. 1). Of the 339 cases identified, 283 patients were eligible for inclusion in the study.
      1Fig. 1. Schematic illustration of study.F01
      White blood cell, neutrophil, lymphocyte and monocyte absolute counts, as well as hematocrit, were obtained from the initial complete blood count performed within 1 h of admission. Differential leukocyte counts were obtained by the Coulter Counter® technique (Coulter Gen-S Hematology Analyzer; Beckman Coulter Corp., Hialeah, Fla., USA). Two physicians independently reviewed the electronic medical records to determine the possible etiology of acute pancreatitis and for potential confounders, including demographic variables, history of comorbidities, acute pancreatitis risk factors and clinical prognostic risk factors at presentation; admission and peak serum amylase and lipase; admission serum creatinine, glucose, calcium, aminotransferases and blood urea nitrogen; and radiological procedures and interventions (table 1). Modified EWS (MEWS; i.e. the four vital signs and the level of consciousness of the patients) was calculated for each eligible index case [...

    Basem Azabet al. Neutrophil-Lymphocyte Ratio as a Predictor of Adverse Outcomes of Acut...

    • ...The area under the curve (AUC) for predicting 60-day mortality was 0.67 [14]...
    • ...In comparison with the original studies [14-17], we had a higher ratio of patients with high scores (MEWS >4: 33% vs. 10% [14], MEDS >12: 11.4% vs. 7% [16], REMS >15: 11.2% vs. 0.8% [17], SCS >7: 23.6% to 25.6% vs. 1.7% [15])...
    • ...In comparison with the original studies [14-17], we had a higher ratio of patients with high scores (MEWS >4: 33% vs. 10% [14], MEDS >12: 11.4% vs. 7% [16], REMS >15: 11.2% vs. 0.8% [17], SCS >7: 23.6% to 25.6% vs. 1.7% [15])...
    • ...The MEWS, SCS, and REMS scores were developed in a general group of patients with low mortality rates (7.9%, 4.7%, and 2.4%, respectively) [14,15,17]...
    • ...The MEWS had a low AUC in the original study [14]...

    Nesrin O Ghanem-Zoubiet al. Assessment of disease-severity scoring systems for patients with sepsi...

    • ... RR, temperature (T), blood pressure (BP) and medical early warning score (MEWS)...

    Patrick B Murphyet al. Neural respiratory drive as a physiological biomarker to monitor chang...

    • ...Various scoring systems have been proposed for identification of patients at risk of deterioration of vital organ functions in the emergency department [6-9]...
    • ...The sum of single vital sign instabilities is sufficient to obtain the VSS, whereas other reported triage scores [7,35,36] use weighted assessments of vital function parameters and require time-consuming calculations and the use of specific scoring tables...

    Tobias M Merzet al. Risk assessment in the first fifteen minutes: a prospective cohort stu...

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