Clinic Study Of MEWS On Evaluating Acute Exacerbation Of COPD(AECOPD) Patients

OBJECTIVE: To estimate the feasibility of MEWS on evaluating acute exacerbation of COPD(AECOPD)patients and therapy options.METHODS: All of 232 patients were evaluated with MEWS instantly and with APACHEⅡwithin 2 hours after being received in the hospital. Their therapy options and prognosis were followed up for 30 days. The correlation of MEWS with APACHEⅡscores, the relationship of MEWS scores with different therapy options and prognosis were statistical analyzed after dividing into groups retrospectively.RESULTS:1. It shows that the MEWS score has positive correlation with the APACHEⅡscore, Pearson correlation coefficient is 0.701.The higher MEWS scores, the higher of mechanic ventilation rate and mortality rate.2. In noninvasive ventilation group, there is no statistic difference between the AUROCC of MEWS(0.708)with the AUROCC of APACHEⅡ(0.770). In invasive ventilation group, the AUROCC of MEWS(0.888)has statistic difference with the AUROCC of APACHEⅡ(0.969). MEWS has the same best cutoff score 5 in noninvasive ventilation group and invasive ventilation group. APACHEⅡhas the best cutoff score 18 in noninvasive ventilation group and the best cutoff score 28 in invasive ventilation group.3. The AUROCC of MEWS(0.926)has no statistic difference with the AUROCC of APACHEⅡ(0.946)on mortality(P＞0.05). MEWS has the best cutoff score 6 on mortality and APACHEⅡhas the best cutoff score 24.CONCLUSION: MEWS can be applied to evaluate the acute exacerbation of COPD(AECOPD)patients, to choose therapy options, and to decide the opportunity and the mechanic ventilation strategy.