Investigation of the value of MEW score and Perfusion Index parameters in identifying critically ill patients- a prospective study

Agit Akgül; Rezan Karaali; Zeynep Karakaya

Makale detayları

Investigation of the value of MEW score and Perfusion Index parameters in identifying critically ill patients- a prospective study

Yazarlar:

Agit Akgül | Rezan Karaali | Zeynep Karakaya

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Osmangazi Tıp Dergisi Vol.45 Issue 4, pp.495-503

Belge Tipi:

Makale

Yayın Tarihi:

7/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001290344

pISSN:

1305-4953

Anahtar kelimeler:

Özet:

 Triage and scoring systems have been developed to differentiate critical patients from others and to ensure early intervention in crowded emergency departments. We aimed to determine the utility of the perfusion index in the triage of patients, and its association with mortality in comparison and combination with the Modified Early Warning score. This was a single-center and prospective study. The study included patients who received yellow or red triage code in emergency department. The modified Early Warning scores were calculated from patients data. The perfusion index value was measured using a Masimo device with probe. The outcomes of the patients and one-month mortality were recorded. 397 patients were included in the study. Mean perfusion index and Modified Early Warning score was 4.05  2.67 and 1.99, respectively in patients discharged from the emergency department, 1.12  0.97 and 7.5, respectively in patients deceased at the emergency department. Finally, the Modified Early Warning score was added to the perfusion index and the effect of the created model on mortality was evaluated. In this case, the new model had an accurate classification rate of 91.7, with a sensitivity of 98.6 and a specificity of 45.1. Nagelkerkes R2 of 0.434 suggested that the model was effective in explaining the dependent variable mortality at a rate of 43.4. It would be possible to make early decisions on intervention and prevent mortality since the combined use of perfusion index and Modified Early Warning score provide higher reliability in identifying critical patients.

 Triage and scoring systems have been developed to differentiate critical patients from others and to ensure early intervention in crowded emergency departments. We aimed to determine the utility of the perfusion index in the triage of patients, and its association with mortality in comparison and combination with the Modified Early Warning score. This was a single-center and prospective study. The study included patients who received yellow or red triage code in emergency department. The modified Early Warning scores were calculated from patients data. The perfusion index value was measured using a Masimo device with probe. The outcomes of the patients and one-month mortality were recorded. 397 patients were included in the study. Mean perfusion index and Modified Early Warning score was 4.05  2.67 and 1.99, respectively in patients discharged from the emergency department, 1.12  0.97 and 7.5, respectively in patients deceased at the emergency department. Finally, the Modified Early Warning score was added to the perfusion index and the effect of the created model on mortality was evaluated. In this case, the new model had an accurate classification rate of 91.7, with a sensitivity of 98.6 and a specificity of 45.1. Nagelkerkes R2 of 0.434 suggested that the model was effective in explaining the dependent variable mortality at a rate of 43.4. It would be possible to make early decisions on intervention and prevent mortality since the combined use of perfusion index and Modified Early Warning score provide higher reliability in identifying critical patients.

 Triage and scoring systems have been developed to differentiate critical patients from others and to ensure early intervention in crowded emergency departments. We aimed to determine the utility of the perfusion index in the triage of patients, and its association with mortality in comparison and combination with the Modified Early Warning score. This was a single-center and prospective study. The study included patients who received yellow or red triage code in emergency department. The modified Early Warning scores were calculated from patients data. The perfusion index value was measured using a Masimo device with probe. The outcomes of the patients and one-month mortality were recorded. 397 patients were included in the study. Mean perfusion index and Modified Early Warning score was 4.05  2.67 and 1.99, respectively in patients discharged from the emergency department, 1.12  0.97 and 7.5, respectively in patients deceased at the emergency department. Finally, the Modified Early Warning score was added to the perfusion index and the effect of the created model on mortality was evaluated. In this case, the new model had an accurate classification rate of 91.7, with a sensitivity of 98.6 and a specificity of 45.1. Nagelkerkes R2 of 0.434 suggested that the model was effective in explaining the dependent variable mortality at a rate of 43.4. It would be possible to make early decisions on intervention and prevent mortality since the combined use of perfusion index and Modified Early Warning score provide higher reliability in identifying critical patients.

 Kalabalık acil servislerde kritik hastaları diğerlerinden ayırmak ve erken müdahaleyi sağlamak için triyaj ve skorlama sistemleri geliştirilmiştir. Hastaların triyajında Perfüzyon indeksinin faydasını ve Modifiye Erken Uyarı skoruMEWS ile karşılaştırma ve kombinasyon halinde mortalite ile ilişkisini belirlemeyi amaçladık. Bu tek merkezli ve prospektif bir çalışmadır. Çalışmaya acil serviste sarı veya kırmızı triyaj kodu alan hastalar dahil edildi. MEWS puanları hasta verilerinden hesaplanmıştır. Perfüzyon indeksi değeri, problu bir Masimo cihazı kullanılarak ölçüldü. Hastaların sonuçları ve bir aylık mortalite durumları kaydedildi. Çalışmaya 397 hasta dahil edildi. Acil servisten taburcu edilen hastalarda ortalama perfüzyon indeksi ve modifiye erken uyarı skoru sırasıyla 4,05  2,67 ve 1,99, acil serviste ölen hastalarda sırasıyla 1,12  0,97 ve 7,5 idi. Son olarak MEWS değeri perfüzyon indeksine eklenmiş ve oluşturulan modelin mortaliteye etkisi değerlendirilmiştir. Bu durumda yeni model, 98,6 hassasiyet ve 45,1 özgüllük ile 91,7 doğru sınıflandırma oranına sahipti. Nagelkerkenin 0,434 olan R2si, modelin bağımlı değişkeni mortalite açıklamada 43,4 oranında etkili olduğunu öne sürdü. Perfüzyon indeksi ve modifiye erken uyarı skorunun birlikte kullanılması kritik hastaların belirlenmesinde daha yüksek güvenilirlik sağladığından müdahale konusunda erken karar vermek ve mortaliteyi önlemek mümkün olacaktır.

Makale detayları

Investigation of the value of MEW score and Perfusion Index parameters in identifying critically ill patients- a prospective study

Yazarlar:

Agit Akgül | Rezan Karaali | Zeynep Karakaya

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Osmangazi Tıp Dergisi Vol.45 Issue 4, pp.495-503

Belge Tipi:

Makale

Yayın Tarihi:

7/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001290344

pISSN:

1305-4953

critically ill

emergency

modified early warning score

perfusion index

triageKritik hasta

Acil

Modifiye erken uyarı skoru

Perfüzyon indeksi

Triyaj

Sayı

Makale detayları

Yazarlar: Agit Akgül | Rezan Karaali | Zeynep Karakaya

Yayıncı: Eskişehir Osmangazi University

Ana Başlıklar: Sağlık Kurumları Yönetimi

Dergi: Osmangazi Tıp Dergisi Vol.45 Issue 4, pp.495-503

Belge Tipi: Makale

Yayın Tarihi: 7/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001290344

pISSN: 1305-4953

Sayı

Yazarlar:

Agit Akgül | Rezan Karaali | Zeynep Karakaya

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Osmangazi Tıp Dergisi Vol.45 Issue 4, pp.495-503

Belge Tipi:

Makale

Yayın Tarihi:

7/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001290344

pISSN:

1305-4953