Derivation and validation of modified early warning score plus SpO2/FiO2 score for predicting acute deterioration of patients with hematological malignancies
Background/Aims Scoring systems play an important role in predicting intensive care unit (ICU) admission or estimating the risk of death in critically ill patients with hematological malignancies. We evaluated the modified early warning score (MEWS) for predicting ICU admissions and in-hospital mort...
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The Korean Association of Internal Medicine
2020-11-01
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| Series: | The Korean Journal of Internal Medicine |
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| Online Access: | http://www.kjim.org/upload/pdf/kjim-2018-438.pdf |
| _version_ | 1818649767480131584 |
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| author | Ju-Ry Lee Youn-Kyoung Jung Hwa Jung Kim Younsuck Koh Chae-Man Lim Sang-Bum Hong Jin Won Huh |
| author_facet | Ju-Ry Lee Youn-Kyoung Jung Hwa Jung Kim Younsuck Koh Chae-Man Lim Sang-Bum Hong Jin Won Huh |
| author_sort | Ju-Ry Lee |
| collection | DOAJ |
| description | Background/Aims Scoring systems play an important role in predicting intensive care unit (ICU) admission or estimating the risk of death in critically ill patients with hematological malignancies. We evaluated the modified early warning score (MEWS) for predicting ICU admissions and in-hospital mortality among at-risk patients with hematological malignancies and developed an optimized MEWS. Methods We retrospectively analyzed derivation cohort patients with hematological malignancies who were managed by a medical emergency team (MET) in the general ward and prospectively validated the data. We compared the traditional MEWS with the MEWS plus SpO2/FiO2 (MEWS_SF) score, which were calculated at the time of MET contact. Results In the derivation cohort, the areas under the receiver-operating characteristic (AUROC) curves were 0.81 for the MEWS (95% confidence interval [CI], 0.76 to 0.87) and 0.87 for the MEWS_SF score (95% CI, 0.87 to 0.92) for predicting ICU admission. The AUROC curves were 0.70 for the MEWS (95% CI, 0.63 to 0.77) and 0.76 for the MEWS_SF score (95% CI, 0.70 to 0.83) for predicting in-hospital mortality. In the validation cohort, the AUROC curves were 0.71 for the MEWS (95% CI, 0.66 to 0.77) and 0.83 for the MEWS_SF score (95% CI, 0.78 to 0.87) for predicting ICU admission. The AUROC curves were 0.64 for the MEWS (95% CI, 0.57 to 0.70) and 0.74 for the MEWS_SF score (95% CI, 0.69 to 0.80) for predicting in-hospital mortality. Conclusions Compared to the traditional MEWS, the MEWS_SF score may be a useful tool that can be used in the general ward to identify deteriorating patients with hematological malignancies. |
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| id | doaj.art-79cd37ff0a3f4741b602ec0d2165a457 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-12-17T01:39:33Z |
| publishDate | 2020-11-01 |
| publisher | The Korean Association of Internal Medicine |
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| spelling | doaj.art-79cd37ff0a3f4741b602ec0d2165a4572022-12-21T22:08:21ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482020-11-013561477148810.3904/kjim.2018.438170326Derivation and validation of modified early warning score plus SpO2/FiO2 score for predicting acute deterioration of patients with hematological malignanciesJu-Ry Lee0Youn-Kyoung Jung1Hwa Jung Kim2Younsuck Koh3Chae-Man Lim4Sang-Bum Hong5Jin Won Huh6 Medical Emergency Team, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Medical Emergency Team, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground/Aims Scoring systems play an important role in predicting intensive care unit (ICU) admission or estimating the risk of death in critically ill patients with hematological malignancies. We evaluated the modified early warning score (MEWS) for predicting ICU admissions and in-hospital mortality among at-risk patients with hematological malignancies and developed an optimized MEWS. Methods We retrospectively analyzed derivation cohort patients with hematological malignancies who were managed by a medical emergency team (MET) in the general ward and prospectively validated the data. We compared the traditional MEWS with the MEWS plus SpO2/FiO2 (MEWS_SF) score, which were calculated at the time of MET contact. Results In the derivation cohort, the areas under the receiver-operating characteristic (AUROC) curves were 0.81 for the MEWS (95% confidence interval [CI], 0.76 to 0.87) and 0.87 for the MEWS_SF score (95% CI, 0.87 to 0.92) for predicting ICU admission. The AUROC curves were 0.70 for the MEWS (95% CI, 0.63 to 0.77) and 0.76 for the MEWS_SF score (95% CI, 0.70 to 0.83) for predicting in-hospital mortality. In the validation cohort, the AUROC curves were 0.71 for the MEWS (95% CI, 0.66 to 0.77) and 0.83 for the MEWS_SF score (95% CI, 0.78 to 0.87) for predicting ICU admission. The AUROC curves were 0.64 for the MEWS (95% CI, 0.57 to 0.70) and 0.74 for the MEWS_SF score (95% CI, 0.69 to 0.80) for predicting in-hospital mortality. Conclusions Compared to the traditional MEWS, the MEWS_SF score may be a useful tool that can be used in the general ward to identify deteriorating patients with hematological malignancies.http://www.kjim.org/upload/pdf/kjim-2018-438.pdfclinical deteriorationhematologic neoplasmsmodified early warning scorepredictionspo2/fio2 ratio |
| spellingShingle | Ju-Ry Lee Youn-Kyoung Jung Hwa Jung Kim Younsuck Koh Chae-Man Lim Sang-Bum Hong Jin Won Huh Derivation and validation of modified early warning score plus SpO2/FiO2 score for predicting acute deterioration of patients with hematological malignancies The Korean Journal of Internal Medicine clinical deterioration hematologic neoplasms modified early warning score prediction spo2/fio2 ratio |
| title | Derivation and validation of modified early warning score plus SpO2/FiO2 score for predicting acute deterioration of patients with hematological malignancies |
| title_full | Derivation and validation of modified early warning score plus SpO2/FiO2 score for predicting acute deterioration of patients with hematological malignancies |
| title_fullStr | Derivation and validation of modified early warning score plus SpO2/FiO2 score for predicting acute deterioration of patients with hematological malignancies |
| title_full_unstemmed | Derivation and validation of modified early warning score plus SpO2/FiO2 score for predicting acute deterioration of patients with hematological malignancies |
| title_short | Derivation and validation of modified early warning score plus SpO2/FiO2 score for predicting acute deterioration of patients with hematological malignancies |
| title_sort | derivation and validation of modified early warning score plus spo2 fio2 score for predicting acute deterioration of patients with hematological malignancies |
| topic | clinical deterioration hematologic neoplasms modified early warning score prediction spo2/fio2 ratio |
| url | http://www.kjim.org/upload/pdf/kjim-2018-438.pdf |
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