Application of Modified Early Warning Score System (MEWS) in the Assessment of Disease Condition and Prognosis of Patients After Neurosurgical Procedure or Intervention.

Abstract

Objective: To evaluate the safety and clinical utility of the corrected Modified Early Warning Score (MEWS) system in predicting postoperative clinical deterioration and long-term prognosis in neurosurgical patients.

Methods: A prospective cohort study was conducted on 344 neurosurgical patients admitted between December 2021 and April 2022. Physiological parameters including axillary temperature, respiratory rate, heart rate, systolic blood pressure, arterial oxygen saturation, and consciousness level were systematically recorded. Patients were monitored for clinical deterioration and final outcomes over a 90-day postoperative period. Receiver operating characteristic (ROC) curve analysis was performed with 90-day mortality as the primary endpoint.

Results: The study demonstrated a significant correlation between elevated corrected MEWS scores and clinical severity (p<0.001). ROC analysis revealed excellent predictive accuracy for 90-day mortality (AUC=0.944), with an optimal cutoff value of 4.5 points demonstrating high sensitivity (92.9%) and specificity (82.0%). The maximum Youden's index of 0.749 further confirmed the robust discriminative capacity of this threshold.

Conclusion: The corrected MEWS scoring system shows strong predictive validity for postoperative clinical deterioration and long-term outcomes in neurosurgical patients.