Modified Early Warning Score as a predictor of intensive care unit readmission within 48 hours: a retrospective observational study
Ahmed N. Balshi, Basim Mohammed Huwait, Alfateh Noor, Abdulrahman Alharthy, Ahmed Fouad Madi, Omar Ramadan, Abdullah Balahmar, Huda Mhawish, Bobby Rose Marasigan, Alva Minette Alcazar, Muhammad Asim Rana, Waleed Aletreby
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.