Modified early warning score: evaluation of trauma patients

A cross-sectional and retrospective study with 115 trauma patients classified as orange (Manchester System), from June 2013 to July 2014. The data were presented as mean and standard deviation, in addition to the Pearson Chi-square test, One-Way ANOVA and Tukey tests.

Results:

from the sample, 81.7% were male with mean age of 39.46±19.71 years. Higher incidence of major trauma (48.7%) and traumatic brain injury (37.4%). At the end of the outcome and MEWS, most cases that had score 1 to 3 were referred to the operating room and the ICU.

Conclusion:

the start point of MEWS was 2 to 3 points, with significant increase in the severity of the situation of patients seen after 6 hours, and approximately half of the individuals underwent surgery, indicating that the scale is a good predictor of severity.

Descriptors:
Emergencies; Emergency Medical Services; Severity of Illness Index; Measures of Association; Exposure; Risk or Outcome

Variable	n (%)
Gender
Male	94 (81.7)
Female	21 (18.3)
Age group
1 - 10 years	3 (2.6)
11 - 20 years	16 (13.9)
21 - 30 years	25 (21.7)
31 - 40 years	24 (20.9)
41 - 50 years	18 (15.6)
51 - 60 years	11 (9.6)
61 - 70 years	7 (6.1)
71 - 80 years	6 (5.2)
81 - 90 years	4 (3.5)
91 - 100 years	1 (0.9)
Hospitalization reason
TBI	43 (37.4)
Extremity trauma	3 (2.6)
Major trauma	56 (48.7)
Abdominal and thoracic trauma	13 (11.3)

MEWS arrival	MEWS 6 hours				p value^* * Pearson Chi-square.
MEWS arrival	Assessment at each 12 hours	Assessment at each 6 hours	Assessment at 30 minutes to 1 hour; assessment at 1 hour and 4 horas	Intensive care	p value^* * Pearson Chi-square.
To assess every 12 hours (1 point)	5	6	0	0
To assess every 6 hours (2 - 3 points)	31	27	6	0
To assess every 30 minutes in 1 hour					0.000
To assess every 1 hour for 4 hours (4 to 6 points)	5	22	7	3
Intensive Care (Equal to or greater than 7 points)	0	0	2	1

Variable	n (%)	P value^ ANOVA One-Way; ICU: Intensive Care Unit.
Outcome at admission
Hospitalization ICU	33 (28.7)
Operating room	60 (52.2)
Death	01 (0.9)
Hospital discharge	21 (18.3)	0,000
Outcome at 6 hours
Hospitalization ICU	40 (34.8)
Operating room	52 (45.2)
Death	02 (1.7)
Hospital discharge	21 (18.3)

MEWS	Outcome				P value^* * Pearson Chi-square; ICU = Intensive Care Unit.
MEWS	ICU Hospitalization	Operating room	Death	Hospital discharge	P value^* * Pearson Chi-square; ICU = Intensive Care Unit.
Assessment every 12 hours (1 point)	12	17	0	12
Assessment every 6 hours (2 to 3 points)	21	26	0	8
Assessment every 30 minutes in 1 hour; assessing every 1 hour for 4 hours (4 to 6 points)	7	7	0	1	0.000
Intensive care (Equal to or greater than 7 points)	0	2	2	0

Trauma type
Variable	TBI n (95%CI)	Trauma of extremity n (95%CI)	Major Trauma n (95%CI)	Abdominal and thoracic Trauma n (95%CI)	P value^* ***** Levine test; TBI = Traumatic brain injury.
Age	35.92-49.80	-6.68-92.68	32.47-42.28	27.12-45.65	0.165
Outcome	43 (1.64-2.36)	3 (2.00-2.00)	56 (1.79-2.29)	13 (1.34-2.97)	0.012

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] CORRESPONDING AUTHOR: Karin Viegas. E-mail: kviegas@gmail.com