The Application Of The Modified Early Warning Score System In Emergency Patients With Brain Injury Combined With The GCS Score System

Objective:The objective is to investigate the application of the modified early warning score system combined with the GCS score system in the triage of emergency patients with brain injury, and to infer the significance in the prediction of the time in hospital, cost of treatment, the prognosis effect, and to provide the basis for emergency triage patients with brain injury.Methods:We selected290patients with brain injury who were included in the standard and treated first through the emergency department of Xiangya Hospital of Central South University from November2013to December2013. Before the preliminary treatment, we used the modified early warning score system and GCS score system to assess the patients and give the scores. Patients’data on the time in hospital, cost of treatment, and the prognosis effect were collected, compared, and analyzed. Data were collected using scales of modified early warning score (MEWS) scale, Glasgow coma scale (GCS), Glasgow outcome scale (GOS). Data were analyzed using SPSS18.0statistical package and the descriptive analysis, variance analysis, chi square test, Spearman’s correlation analysis, and AUROC curve analysis were performed.Results:290people completed the follow-up of3months,5cases died,6lost to follow-up.1.The average score of MEWS of290patients with brain injury was1.87±1.55(1～12), while the average score of GCS was13.85±2.25(3～15). The average score of GOS:4.73±0.69(1～5). Cost of treatment in patients with brain injury was77508.75±7778.48(5647±129045) Treatment time was24.33±7.83days (1±43). The mortality was1.72%.2. The correlation detection with statistical of MEWS in the length of hospital stay, cost of treatment, prognosis of patients was significantly different (P<0.05), the higher the score of MEWS, the longer of the patients of the length of hospital stay, the higher of the cost of treatment, the worse of the prognosis; The correlation detection with statistical of MEWS and GCS and GOS was significantly different (P<0.05), with a negative correlation.3. The AUROCC area of the MEWS was0.973and the optimum truncation points was16points, sensitivity80.00%, specificity77.4%), and was significant to assess the severity of the condition of emergency patients with brain injury.Conclusion:1. MEWS score system is to assess the vital signs of patients early, and GCS system are mainly focus the awareness of patients and motion rate. Combination of MEWS and GCS is better to assess the severity of the emergency patients with brain injury.2. Cut-off point of the MEWS is satisfactory. It has high value in the prediction of the emergency prognosis of patients with brain injury. Its best predict defines value is5points. Patients’score above5points has increased risk of death and need quick assessment and management, and early intervention.3. Emergency MEWS score of the patients with traumatic brain injury are correlated with the length of hospital stay, cost of treatment and prognosis.