MEWS And APACHE â…¡Score In The Disposal Process To Explore The Role Of Acute And Critically Ill Patient

Objective:To access the ability of triage,handle and evaluate the prognosis of critically ill patients by Modified early warming score(MEWS) and acute physiology and chronic health evaluations Ⅱ (APACHE Ⅱ). Methods:A single-center prospective observational study was conducted. A total of 266patients of First Affiliated Hospital of Xinjiang Medical University from June 2012 to January 2013 were enrolled. All patient scored with MEWS and APACHE Ⅱ score respectively;patient out come,intensive care unit (ICU) admission,High dependency unit (HDU) admission,outpatient death,hospital discharge in 30 days.The diagnostic and predictive performance of MEWS and APACHE II score were assessed by the receiver operating characteristic curve (ROC). Results:As high as the MEWS and APACHEⅡ score were the patients condition were more critical,the probability of HDU and ICU admission and mortality is high.When A Score max of 5 or more was associated with an increase risk death,ICU admission and HDU admission for NEWS.Ratio of severity patient in score of 5 or more was significantly higher than that of score of less to 5 (χ2=90.749, P=0.000),with sensitivity was 85.70% and the specificity was 84.80%.The sensitivity was80.00% and the specificity was 91.10%,when 5 of MEWS were used to discriminate the ICU admission of patients;The sensitivity was67.90% and the specificity was 79.90% for HDU admission.When A Score max of 21 or more was associated with an increase risk death for APACHE Ⅱ.Ratio of severity patient in score of 21 or more was significantly higher than that of score of less to 21(χ2=73.518, P=0.000).with sensitivity was 90.50% and the specificity was 79.50 %.The sensitivity was95.00% and the specificity was 73.60%,when 21 of APACHE Ⅱ were used to discriminate the ICU admission of patients;The sensitivity was88.20% and the specificity was 72.80% for HDU admission.Predicted out comes.,ICU admission and HDU admission,The AUC and respectively 95% of MEWS and APACHE Ⅱ score was 0.889 (0.830～0.948),0.937 (0.900～0.975);0.946(0.916～0.977),0.939 (0.898～ 0.979);0.761(0.677～0.845),0.832(0.782～0.883).Conclusion:APACHE Ⅱ and MEWS score both have the ability to estimate the seriously ill patient and both can identify the potential serious patient.MEWS score is more sheep quickly convenient more suitable for early identification for critical ill patient.APACHEII score is more suitable for has been observing the patient in intensive care.