Commentaar op het artikel over de MEW score: voorspelt opname en mortaliteit

Vorwerk C. MEWS: predicts hospital admission and mortality in emergency department patients. Emerg Med J 2009 Jun;26(6):466.

The paper by Burch et al1 on the modified early warning (MEW) score predicting hospital admission and inhospital mortality is both interesting and topical.

I agree with the authors that the MEW score, a risk assessment tool now widely used in UK emergency departments (ED) to facilitate the early identification of high-risk patients, is a good predictor of inhospital mortality.2 I also share the authors’ concerns that there are limitations to using the MEW score and that the MEW score needs to be interpreted in context with other clinical findings associated with a risk of adverse outcome. This is supported by our findings among adult ED patients admitted to hospital, in whom 33% of non-survivors were found to have low ED arrival MEW scores (0–2).

However, I have some concerns regarding the methodology of the described study. It is not clear when the physiological parameters to calculate the MEW score were taken, whether on arrival, before discharge/admission, or whether the worst ever recorded measurement had been used? Not knowing how the MEW score was determined in this cohort affects its practical application.

lees hier het volledige commentaar

verwijzing naar het artikel Modified early warning score predicts the need for hospital admission and inhospital mortality

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