The efficacies of modified early warning score and mainz emergency evaluation score for prediction of the prognosis in the evaluation of patients attending to TOMC emergency department

Background: Recently, there is an increasing interest for scoring systems to evaluate the serious patients by means of the severeness of the disease and their availibility for discharge in the emergency departments and intensive care units. Our aim in this study is to evaluate the efficiency of the mEWS and MEES systems in assessing the severeness of the disease and foreseing the mid term prognosis of the patients hospitalized following their emergency care in our emergency room.Material and Method: Patients attended to Inonu University Turgut Ozal Medical Center Department of Emergency Medicine and hospitalized following their emergency care (1051 patients) between 01 January and 15 February 2011 were included to our study. The effects of age, sex, triage categories, ED check in times, mEWS and MEES scores on the area of hospitalization and mortality was evaluated. Statistical analyses were performed by SPSS for windows version 16.0. The data were summarized as means, standart deviation and percents. Univariate and multiavriate analyses were performed for risk factor calculations.Results: The mean age of the patients was 58±19 and 584 (56%) were male. Triage group 1 patients accounted for 21 of all (2%) while 646 (61%) was group 2 and 384 (37%) was triage group 3. Of all patients, 341 (32%) was hospitalized to ICU. While discharged patients were 89% (935 patients) of the study group, 116 patients (11%) were dead at the hospital. The GCS, AVPU and mEWS values were statistically significant by means of patient mortality (p<0.0001), but the delta MEES value was not (p<0.127). The multivariate analysis showed that age clusters, GCS and mEWS values were risk factors for mortality, while age clusters, GCS and AVPU values were risk factors for ICU hospitalizations.Conclusion: The results of our stuy suggests that mEWS evaluation is an effective and reliable tool for predicting outcome and hospitalization units of ED patients. Our results also displayed that the easily available GCS and AVPU scales are reliable guides in patient management. MEES values, on the other hand, are not convenient for ED use.