Biomarkers, shock index and modified early warning score among older medical hospital inpatients in Nigeria
Background: Biomarkers, shock index and modified early warning score (MEWS) are of public health importance because identification and prompt attention to them have been found to reduce mortality among older patients on admission. Objectives: A study was undertaken to determine the biomarkers, shock...
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| Format: | Article |
| Language: | English |
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AOSIS
2019-07-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/4964 |
| _version_ | 1818345405379772416 |
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| author | L. A. Adebusoye M. O. Owolabi A. Ogunniyi |
| author_facet | L. A. Adebusoye M. O. Owolabi A. Ogunniyi |
| author_sort | L. A. Adebusoye |
| collection | DOAJ |
| description | Background: Biomarkers, shock index and modified early warning score (MEWS) are of public health importance because identification and prompt attention to them have been found to reduce mortality among older patients on admission.
Objectives: A study was undertaken to determine the biomarkers, shock index and MEWS that predict mortality on admission among older medical hospital inpatients.
Methods: This was a prospective study of 450 patients (≥ 60 years) on the medical wards of University College Hospital, Ibadan. Biomarkers recommended by the National Institute on Aging such as blood pressure, heart rate and pulse rate (cardiovascular functioning); cholesterol and triglycerides (metabolic processes); T-cell counts (immune system status) and weight, body mass index and waist-to-hip ratio (indicators of obesity, chronic metabolic disorders and fat deposits) were assessed. Vital signs were recorded on admission and used to calculate the shock index and MEWS. Multivariate and survival analyses were carried out at p 0.05.
Results: Baseline temperature ≥ 39.0°c (p = 0.049), pulse rate ≥ 100 beats/minute (p = 0.034), systolic blood pressure (SBP) 120 mmHg (p = 0.048), shock index ≥1.0 (p = 0.041), age shock index (p = 0.032) and critical illness score (MEWS ≥5) p = 0.019 were significantly associated with mortality. Independent predictors of mortality on Cox regression analysis were temperature ≥ 39.0°C (HR = 3.317 [1.281–8.590]) and SBP 120 mmHg (HR = 1.845 [1.025–3.322]).
Conclusion: Prompt identification and management of fever and low blood pressure should improve the survival of older medical hospital inpatients. |
| first_indexed | 2024-12-13T17:01:51Z |
| format | Article |
| id | doaj.art-0ffbc3a26e7f47e3a6efcefa898e14b2 |
| institution | Directory Open Access Journal |
| issn | 2078-6190 2078-6204 |
| language | English |
| last_indexed | 2024-12-13T17:01:51Z |
| publishDate | 2019-07-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj.art-0ffbc3a26e7f47e3a6efcefa898e14b22022-12-21T23:37:46ZengAOSISSouth African Family Practice2078-61902078-62042019-07-0161310.4102/safp.v61i3.49643940Biomarkers, shock index and modified early warning score among older medical hospital inpatients in NigeriaL. A. Adebusoye0M. O. Owolabi1A. Ogunniyi2University College Hospital, IbadanUniversity of Ibadan, IbadanUniversity of Ibadan, IbadanBackground: Biomarkers, shock index and modified early warning score (MEWS) are of public health importance because identification and prompt attention to them have been found to reduce mortality among older patients on admission. Objectives: A study was undertaken to determine the biomarkers, shock index and MEWS that predict mortality on admission among older medical hospital inpatients. Methods: This was a prospective study of 450 patients (≥ 60 years) on the medical wards of University College Hospital, Ibadan. Biomarkers recommended by the National Institute on Aging such as blood pressure, heart rate and pulse rate (cardiovascular functioning); cholesterol and triglycerides (metabolic processes); T-cell counts (immune system status) and weight, body mass index and waist-to-hip ratio (indicators of obesity, chronic metabolic disorders and fat deposits) were assessed. Vital signs were recorded on admission and used to calculate the shock index and MEWS. Multivariate and survival analyses were carried out at p 0.05. Results: Baseline temperature ≥ 39.0°c (p = 0.049), pulse rate ≥ 100 beats/minute (p = 0.034), systolic blood pressure (SBP) 120 mmHg (p = 0.048), shock index ≥1.0 (p = 0.041), age shock index (p = 0.032) and critical illness score (MEWS ≥5) p = 0.019 were significantly associated with mortality. Independent predictors of mortality on Cox regression analysis were temperature ≥ 39.0°C (HR = 3.317 [1.281–8.590]) and SBP 120 mmHg (HR = 1.845 [1.025–3.322]). Conclusion: Prompt identification and management of fever and low blood pressure should improve the survival of older medical hospital inpatients.https://safpj.co.za/index.php/safpj/article/view/4964biomarkersmewsnigeriaolder patientsshock index |
| spellingShingle | L. A. Adebusoye M. O. Owolabi A. Ogunniyi Biomarkers, shock index and modified early warning score among older medical hospital inpatients in Nigeria South African Family Practice biomarkers mews nigeria older patients shock index |
| title | Biomarkers, shock index and modified early warning score among older medical hospital inpatients in Nigeria |
| title_full | Biomarkers, shock index and modified early warning score among older medical hospital inpatients in Nigeria |
| title_fullStr | Biomarkers, shock index and modified early warning score among older medical hospital inpatients in Nigeria |
| title_full_unstemmed | Biomarkers, shock index and modified early warning score among older medical hospital inpatients in Nigeria |
| title_short | Biomarkers, shock index and modified early warning score among older medical hospital inpatients in Nigeria |
| title_sort | biomarkers shock index and modified early warning score among older medical hospital inpatients in nigeria |
| topic | biomarkers mews nigeria older patients shock index |
| url | https://safpj.co.za/index.php/safpj/article/view/4964 |
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