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首页> 外文期刊>Italian Journal of Medicine >The Niguarda MEWS, a new and refined tool to determine criticality and instability in Internal Medicine Ward and Emergency Medicine Unit
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The Niguarda MEWS, a new and refined tool to determine criticality and instability in Internal Medicine Ward and Emergency Medicine Unit

机译：Niguarda MEWS，一种新的改进工具，用于确定内科病房和急诊科的危急程度和不稳定性

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This study compares the effect of the modified early warning score (MEWS) versus a new early warning system (Niguarda MEWS) for detecting instability and criticality in hospital medical departments. A retrospective observational study was conducted in the Internal Medicine ward of Niguarda Ca’ Granda Hospital in Milan between November 2013 and October 2014. MEWS and Niguarda-MEWS were gathered using: systolic blood pressure, respiratory frequency, heart rate, temperature, level of consciousness, oxygen saturation, creatinine level, hematocrit level and age. In order to determine if the patient was critical or not the MEWS criticality cut-off value chosen was 3, while in the Niguarda MEWS it was 6. The primary outcome was the correlation between the critical level of the two scores and in-hospital mortality. The secondary endpoint was the correlation between a specific disease and the two scores. In the study, 471 patients were included, using both the MEWS and the Niguarda MEWS score at admittance: 33.4% of patients turned out to be critically ill using the former, 40.98% when using the latter. Therefore, the specificity of scores was 70% for MEWS and 73% for Niguarda MEWS, the sensitivity 58% for MEWS and 63% for Niguarda MEWS, Niguarda MEWS area under the curve (AUC): 0.736, MEWS AUC: 0.670. For the secondary outcome, the new score is higher for genitourinary and respiratory diseases. Niguarda-MEWS could be an optimal tool to detect criticality and instability in order to address the patient to the right level of care.
机译：这项研究比较了修改后的预警评分（MEWS）与新的预警系统（Niguarda MEWS）在医院医疗部门检测不稳定性和严重性的效果。 2013年11月至2014年10月，在米兰的Niguarda Ca'Granda医院内科病房进行了一项回顾性观察研究。MEWS和Niguarda-MEWS的使用是：收缩压，呼吸频率，心率，体温，意识水平，血氧饱和度，肌酐水平，血细胞比容水平和年龄。为了确定患者是否危急，选择的MEWS危急临界值是3，而在Niguarda MEWS中是6。主要结果是两个评分的危重程度与院内死亡率之间的相关性。 。次要终点是特定疾病与两个评分之间的相关性。在该研究中，入院时同时使用MEWS和Niguarda MEWS评分纳入了471名患者：33.4％的患者被发现是重病，前者为40.98％。因此，MEWS的得分特异性为70％，Niguarda MEWS的得分特异性为73％，MEWS的敏感性为58％，Niguarda MEWS的敏感性为63％，曲线下的Niguarda MEWS面积（AUC）：0.736，MEWS AUC：0.670。对于次要结果，泌尿生殖系统和呼吸系统疾病的新分数更高。 Niguarda-MEWS可能是检测关键性和不稳定性的最佳工具，以便为患者提供适当的护理。

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