Comparative research on the prognostic ability of improved early warning and APACHE Ⅱ evaluation for hospitalized patients in the emergency department

Objective： To compare the feasibility and applicability of predicting the prognosis of patients using the Early Warning Score（MEWS） system and the Acute Physiology and Chronic Health Evaluation（APACHE Ⅱ） system in the Emergency Department.Methods： Using a prospective study method, the APACHE Ⅱ and MEWS data for 640 patients hospitalized in the Emergency Internal Medicine Department were collected. The prognoses, two scores to predict the corresponding prediction index of sensitivity, specificity and positive predictive value for the prognosis,the negative predictive value and the ROC curve for predicting the prognosis were analyzed for all patients.Results： In the prediction of the risk of mortality, the MEWS system had a high resolution. The MEWS area under the ROC curve was 0.93. The area under the ROC curve for the APACHE score was 0.79, and the difference was statistically significant（Z =4.348, P 〈 0.01）.Conclusions： Both the MEWS and APACHE Ⅱ systems can be used to determine the severity of emergency patients and have a certain predictive value for the patient＇s mortality risk. However, the MEWS system is simple and quick to operate, making it a useful supplement for APACHE Ⅱ score.