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Modified Early Warning Score como preditor de readmissão à unidade de terapia intensiva dentro de 48 horas: um estudo observacional retrospectivo / Modified Early Warning Score as a predictor of intensive care unit readmission within 48 hours: a retrospective observational study
Balshi, Ahmed Naji; Huwait, Basim Mohammed; Noor, Alfateh Sayed Nasr; Alharthy, Abdulrahman Mishaal; Madi, Ahmed Fouad; Ramadan, Omar Elsayed; balahmar, Abdullah; Mhawish, Huda A; Marasigan, Bobby Rose; Alcazar, Alva Minette; Rana, Muhammad Asim; Aletreby, Waleed Tharwat.
  • Balshi, Ahmed Naji; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Huwait, Basim Mohammed; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Noor, Alfateh Sayed Nasr; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Alharthy, Abdulrahman Mishaal; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Madi, Ahmed Fouad; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Ramadan, Omar Elsayed; King Saud Medical City. Critical Care Department. Riyadh. SA
  • balahmar, Abdullah; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Mhawish, Huda A; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Marasigan, Bobby Rose; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Alcazar, Alva Minette; King Saud Medical City. Critical Care Department. Riyadh. SA
  • Rana, Muhammad Asim; Bahria Town International Hospital. Internal Medicine and Critical Care Department. Lahore. PK
  • Aletreby, Waleed Tharwat; King Saud Medical City. Critical Care Department. Riyadh. SA
Rev. bras. ter. intensiva ; 32(2): 301-307, Apr.-June 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1138479
RESUMO
RESUMO

Objetivo:

Avaliar a hipótese de que o Modified Early Warning Score (MEWS) por ocasião da alta da unidade de terapia intensiva associa-se com readmissão, e identificar o nível desse escore que prediz com maior confiabilidade a readmissão à unidade de terapia intensiva dentro de 48 horas após a alta.

Métodos:

Este foi um estudo observacional retrospectivo a respeito do MEWS de pacientes que receberam alta da unidade de terapia intensiva. Comparamos dados demográficos, escores de severidade, características da doença crítica e MEWS de pacientes readmitidos e não readmitidos. Identificamos os fatores associados com a readmissão em um modelo de regressão logística. Construímos uma curva Característica de Operação do Receptor para o MEWS na predição da probabilidade de readmissão. Por fim, apresentamos o critério ideal com maior sensibilidade e especificidade.

Resultados:

A taxa de readmissões foi de 2,6%, e o MEWS foi preditor significante de readmissão, juntamente do tempo de permanência na unidade de terapia intensiva acima de 10 dias e traqueostomia. A curva Característica de Operação do Receptor relativa ao MEWS para predizer a probabilidade de readmissão teve área sob a curva de 0,82, e MEWS acima de 6 teve sensibilidade de 0,78 (IC95% 0,66 - 0,9) e especificidade de 0,9 (IC95% 0,87 - 0,93).

Conclusão:

O MEWS associa-se com readmissão à unidade de terapia intensiva, e o escore acima de 6 teve excelente precisão como preditor prognóstico.
ABSTRACT
ABSTRACT

Objective:

To evaluate the hypothesis that the Modified Early Warning Score (MEWS) at the time of intensive care unit discharge is associated with readmission and to identify the MEWS that most reliably predicts intensive care unit readmission within 48 hours of discharge.

Methods:

This was a retrospective observational study of the MEWSs of discharged patients from the intensive care unit. We compared the demographics, severity scores, critical illness characteristics, and MEWSs of readmitted and non-readmitted patients, identified factors associated with readmission in a logistic regression model, constructed a Receiver Operating Characteristic (ROC) curve of the MEWS in predicting the probability of readmission, and presented the optimum criterion with the highest sensitivity and specificity.

Results:

The readmission rate was 2.6%, and the MEWS was a significant predictor of readmission, along with intensive care unit length of stay > 10 days and tracheostomy. The ROC curve of the MEWS in predicting the readmission probability had an AUC of 0.82, and a MEWS > 6 carried a sensitivity of 0.78 (95%CI 0.66 - 0.9) and specificity of 0.9 (95%CI 0.87 - 0.93).

Conclusion:

The MEWS is associated with intensive care unit readmission, and a score > 6 has excellent accuracy as a prognostic predictor.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Patient Readmission / Critical Illness / Early Warning Score / Intensive Care Units Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Male Language: English / Portuguese Journal: Rev. bras. ter. intensiva Journal subject: Critical Care Year: 2020 Type: Article Affiliation country: Pakistan / Saudi Arabia Institution/Affiliation country: Bahria Town International Hospital/PK / King Saud Medical City/SA

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Full text: Available Index: LILACS (Americas) Main subject: Patient Readmission / Critical Illness / Early Warning Score / Intensive Care Units Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Male Language: English / Portuguese Journal: Rev. bras. ter. intensiva Journal subject: Critical Care Year: 2020 Type: Article Affiliation country: Pakistan / Saudi Arabia Institution/Affiliation country: Bahria Town International Hospital/PK / King Saud Medical City/SA