PMID: 22580592May 15, 2012Paper

The use of Modified Early Warning Score may help anesthesists in postoperative level of care selection in emergency abdominal surgery

Minerva anestesiologica
A PerisP Bechi

Abstract

The Modified Early Warning Score (MEWS) was proposed for early identification of patients deterioration. The purpose of this study was to determine if MEWS calculation can help the anaesthesist select the correct level of care to avoid inappropriate admission to the ICU and to enhance the use of the High Dependency Unit (HDU) after emergency surgical procedures. Emergency surgical patients admitted before MEWS application (Jan 2008-Mar 2009) were included in the control group, whereas emergency surgical patients after MEWS introduction constituted the intervention group (Apr 2009-Jan 2010). Admission diagnosis was included into three groups for data analysis: acute abdomen (intestinal occlusion, bowel perforation, intestinal ischemia), non-complicated surgery (hernia recurrence, cholecystitis, appendicitis), and blunt abdominal trauma. In intervention group, MEWS was calculated by the anaesthesists on duty before and after surgical procedure. Patients with a MEWS of 3 or 4 were transferred to the HDU, whereas a MEWS score of 5 or more was considered criteria for ICU admission. A total of 1082 patients were enrolled in this study. The control group was made up of 604 patients, whereas the MEWS group included 478 patients. Baseli...Continue Reading

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