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Research Journal of Medical Sciences

ISSN: Online 1993-6095
ISSN: Print 1815-9346
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To Determine the Significance of Modified Early Warning Score as a Prognostic Factor in Patients Presenting to the Emergency Department with Shock

B. Dhiran Showri, B.S. Gopala Krishna, V. Ravi Sankar, Raghu Kondle and L. Manikanta Chaitanya
Page: 194-202 | Received 25 Sep 2024, Published online: 19 Dec 2024

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https://doi.org/10.36478/10.36478/makrjms.2025.1.194.202

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Abstract

The present study was conducted on 80 patients in the department of emergency medicine, Narayana Medical College and Hospital, Nellore, over a period of two years. The shock was diagnosed as systolic BP <90mmHg, signs and symptoms of shock with serum lactate level >1.5. Restless and weak rapid pulse were frequent among the symptoms. The males and females are 62.5% and 37.5%. 65 (81.25%) patients had ICU admissions and 15 (18.75%) patients had ward admissions. 57 (71.25%) patients required inotropic support and 23 (28.75%) patients did not require any inotropic support. Mortality was seen in 26 (32.5%) patients and 54 (67.5%) patients were discharged. 37 patients (46.3%) required ventilator support and 43 (53.8%) patients did not require any ventilator support. 70 patients (87.5%) have MEWS score >5 and 10 (12.5%) patients have MEWS score <5. Out of 70 patients have MEWS score >5, sixty‐one patients have admitted in ICU and nine patients have admitted in Wards., mortality was seen in twenty‐five patients., thirty‐six patients required ventilator support. MEWS score was significant predictor for the Length of Hospital stay. MEWS had a significant correlation in predicting outcomes in shock. Only one (1.3%) patient has a NEWS score less than 1, 4 (5%) patients have a score between 5 and 6 and 75 (93.8%) patients have scored >7. Among Seventy‐five patients of NEWS score >7, 64 patients were admitted in ICU and 11 patients in Ward., 26 patients attained mortality., 37 required ventilator support. Only 1 (1.3%) patient has REMS score between 0‐2, 19 (23.8%) patients have score between3‐5, 33 (41.3%) patients have score between 6 to 9, 18 (22.5%) patients have score 10‐11, and 9 (11.3%) patients have score between 12‐13. Among thirty‐three patients of REMS score between 6 and 9, 25 patients were admitted in ICU and eight patients in Ward; 15 patients required ventilator support. The shock index was not a significant predictor of in‐hospital mortality. For ICU admissions, AUC values of MEWS, NEWS and REMS are 0.835, 0.856 and 0.712, respectively. For In‐Hospital Mortality, AUC values of MEWS, NEWS, and REMS are 0.740, 0.801, and 0.906, respectively. MEWS and NEWS both performed well with significant results, but in a crowded ED population and in ED’s lacking O2 supply, NEWS cannot be used. Considering the limitations of the study, And the simplicity and feasibility of MEWS, the overall performance of MEWS in the ED was significance. MEWS to be more accurate, it should be studied in a large group of populations and in multi‐centers.

How to cite this article:

B. Dhiran Showri, B.S. Gopala Krishna, V. Ravi Sankar, Raghu Kondle and L. Manikanta Chaitanya. To Determine the Significance of Modified Early Warning Score as a Prognostic Factor in Patients Presenting to the Emergency Department with Shock.
DOI: https://doi.org/10.36478/10.36478/makrjms.2025.1.194.202
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2025.1.194.202