<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jccm-2021-0040_s_006">
<h3>Introduction</h3>
<p>The medical emergency team enables the limitation of patients’ progression to critical illness in the general ward. The early warning scoring system (EWS) is one of the criteria for medical emergency team activation; however, it is not a valid criterion to predict the prognosis of patients with MET activation.</p></sec>
<sec id="j_jccm-2021-0040_s_007">
<h3>Aim</h3>
<p>In this study, the National Early Warning Score (NEWS) and Rapid Emergency Medicine Score (REMS) was compared with that of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting the prognosis of patients who had been treated a medical emergency team.</p></sec>
<sec id="j_jccm-2021-0040_s_008">
<h3>Material and Methods</h3>
<p>In this single-centre retrospective cohort study, patients treated by a medical emergency team between April 2013 and March 2019 and the 28-day prognosis of MET-activated patients were assessed using APACHE II, NEWS, and REMS.</p></sec>
<sec id="j_jccm-2021-0040_s_009">
<h3>Results</h3>
<p>Of the 196 patients enrolled, 152 (77.5%) were men, and 44 (22.5%) were women. Their median age was 68 years (interquartile range: 57-76 years). The most common cause of medical emergency team activation was respiratory failure (43.4%). Univariate analysis showed that APACHE II score, NEWS, and REMS were associated with 28-day prognostic mortality. There was no significant difference in the area under the receiver operating characteristic curve of APACHE II (0.76), NEWS (0.67), and REMS (0.70); however, the sensitivity of NEWS (0.70) was superior to that of REMS (0.47).</p></sec>
<sec id="j_jccm-2021-0040_s_010">
<h3>Conclusion</h3>
<p>NEWS is a more sensitive screening tool like APACHE II than REMS for predicting the prognosis of patients with medical emergency team activation. However, because the accuracy of NEWS was not sufficient compared with that of APACHE II score, it is necessary to develop a screening tool with higher sensitivity and accuracy that can be easily calculated at the bedside in the general ward.</p></sec>
</abstract>

Introduction
The medical emergency team enables the limitation of patients’ progression to critical illness in the general ward. The early warning scoring system (EWS) is one of the criteria for medical emergency team activation; however, it is not a valid criterion to predict the prognosis of patients with MET activation.

Aim
In this study, the National Early Warning Score (NEWS) and Rapid Emergency Medicine Score (REMS) was compared with that of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting the prognosis of patients who had been treated a medical emergency team.

Material and Methods
In this single-centre retrospective cohort study, patients treated by a medical emergency team between April 2013 and March 2019 and the 28-day prognosis of MET-activated patients were assessed using APACHE II, NEWS, and REMS.

Results
Of the 196 patients enrolled, 152 (77.5%) were men, and 44 (22.5%) were women. Their median age was 68 years (interquartile range: 57-76 years). The most common cause of medical emergency team activation was respiratory failure (43.4%). Univariate analysis showed that APACHE II score, NEWS, and REMS were associated with 28-day prognostic mortality. There was no significant difference in the area under the receiver operating characteristic curve of APACHE II (0.76), NEWS (0.67), and REMS (0.70); however, the sensitivity of NEWS (0.70) was superior to that of REMS (0.47).

Conclusion
NEWS is a more sensitive screening tool like APACHE II than REMS for predicting the prognosis of patients with medical emergency team activation. However, because the accuracy of NEWS was not sufficient compared with that of APACHE II score, it is necessary to develop a screening tool with higher sensitivity and accuracy that can be easily calculated at the bedside in the general ward.

Comparison of the National Early Warning Scores and Rapid Emergency Medicine Scores with the APACHE II Scores as a Prediction of Mortality in Patients with Medical Emergency Team Activation: A Single-centre Retrospective Cohort Study

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction
The medical emergency team enables the limitation of patients’ progression to critical illness in the general ward. The early warning scoring...

Comparison of the National Early Warning Scores and Rapid Emergency Medicine Scores with the APACHE II Scores as a Prediction of Mortality in Patients with Medical Emergency Team Activation: A Single-centre Retrospective Cohort Study

Article Category: Research article

Published Online: Nov 06, 2021

Page range: 283 - 289

Received: Mar 18, 2021

Accepted: Oct 10, 2021

DOI: https://doi.org/10.2478/jccm-2021-0040

Keywords
medical emergency team, Acute Physiology and Chronic Health Evaluation II, National Early Warning Score, Rapid Emergency Medicine Score

© 2021 Junpei Haruna, Hiroomi Tatsumi, Satoshi Kazuma, Hiromitsu Kuroda, Yuya Goto, Wakiko Aisaka, Hirofumi Terada, Tomoko Sonoda, Yoshiki Masuda, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Comparison of the National Early Warning Scores and Rapid Emergency Medicine Scores with the APACHE II Scores as a Prediction of Mortality in Patients with Medical Emergency Team Activation: A Single-centre Retrospective Cohort Study

Article Category: Research article

Published Online: Nov 06, 2021

Page range: 283 - 289

Received: Mar 18, 2021

Accepted: Oct 10, 2021

DOI: https://doi.org/10.2478/jccm-2021-0040

Keywordsmedical emergency team, Acute Physiology and Chronic Health Evaluation II, National Early Warning Score, Rapid Emergency Medicine Score

© 2021 Junpei Haruna, Hiroomi Tatsumi, Satoshi Kazuma, Hiromitsu Kuroda, Yuya Goto, Wakiko Aisaka, Hirofumi Terada, Tomoko Sonoda, Yoshiki Masuda, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
medical emergency team, Acute Physiology and Chronic Health Evaluation II, National Early Warning Score, Rapid Emergency Medicine Score