{"title":"改良早期预警评分系统(MEWS)在神经外科手术或干预后患者病情及预后评估中的应用","authors":"Ping Liu, Jiao Xu, Yuhua Liu, Xuexuan Wang, Qili Tan, Ying Wang","doi":"10.2147/RMHP.S532103","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The corrected MEWS scoring system shows strong predictive validity for postoperative clinical deterioration and long-term outcomes in neurosurgical patients.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2693-2699"},"PeriodicalIF":2.0000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372822/pdf/","citationCount":"0","resultStr":"{\"title\":\"Application of Modified Early Warning Score System (MEWS) in the Assessment of Disease Condition and Prognosis of Patients After Neurosurgical Procedure or Intervention.\",\"authors\":\"Ping Liu, Jiao Xu, Yuhua Liu, Xuexuan Wang, Qili Tan, Ying Wang\",\"doi\":\"10.2147/RMHP.S532103\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The corrected MEWS scoring system shows strong predictive validity for postoperative clinical deterioration and long-term outcomes in neurosurgical patients.</p>\",\"PeriodicalId\":56009,\"journal\":{\"name\":\"Risk Management and Healthcare Policy\",\"volume\":\"18 \",\"pages\":\"2693-2699\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-08-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372822/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Risk Management and Healthcare Policy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/RMHP.S532103\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Risk Management and Healthcare Policy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/RMHP.S532103","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Application of Modified Early Warning Score System (MEWS) in the Assessment of Disease Condition and Prognosis of Patients After Neurosurgical Procedure or Intervention.
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.
期刊介绍:
Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include:
Public and community health
Policy and law
Preventative and predictive healthcare
Risk and hazard management
Epidemiology, detection and screening
Lifestyle and diet modification
Vaccination and disease transmission/modification programs
Health and safety and occupational health
Healthcare services provision
Health literacy and education
Advertising and promotion of health issues
Health economic evaluations and resource management
Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.