Table 1
Patient characteristics
| Total (n=196) | Survivors (n=152) | Non-survivors (n=44) | p-value | |
|---|---|---|---|---|
| Age (years), [Median, IQR] | 68(57-76) | 67.5(56-76) | 67.7(63-77) | 0.18 |
| Male, n. (%) | 152(77.5) | 121(79.6) | 31(70.4) | 0.21 |
| Transferred to ICU post-MET, n (%) | 134(68.4) | 96(49.0) | 38(86.4) | <0.01 |
| CCI, [Mean (SD)] | 1.05(1.44) | 1.06 (1.48) | 0.97(1.29) | 0.94 |
| SOFA, [Median, IQR] | 6(4-8) | 5(4-7) | 9(7-12) | <0.01 |
| Illness category, surgical, n (%) | 122(62.2) | 98(64.5) | 24(54.5) | 0.29 |
| Reason of MET triggers, n (%) | ||||
| Respiratory | 85(43) | 62(41) | 23(52) | 0.22 |
| Cardiovascular | 45(23) | 37(24) | 8(18) | 0.39 |
| Neurology | 18(9) | 15(10) | 3(7) | 0.38 |
| Haemorrhage | 15(8) | 12(8) | 3(7) | 0.06 |
| Others | 33(17) | 26(17) | 7(16) | 0.85 |
Fig. 1
Study inclusion flow chart.
Table 2
Comparison of vital signs and physical status in the survivor group and the non-survivor group
| Total (n=196) | Survivor group (n=152) | Non-survivor group (n=44) | p-value | |
|---|---|---|---|---|
| Body temperature (°C), [Median, IQR] | 37.2(36.5-37.5) | 36.8(36.5-37.4) | 37.0(36.7-37.7) | 0.95 |
| Pulse rate (/min), [Median, IQR] | 100(80-120) | 92(80-120) | 110(80-121) | 0.15 |
| Respiratory rate (/min), [Median, IQR] | 27(20-30) | 24(20-30) | 27(20-31) | 0.10 |
| SpO2 (%), [Median, IQR] | 95(88-98) | 94(90-98) | 90(85-95) | 0.02 |
| Systolic arterial pressure (mmHg), [Median, IQR] | 109(74-130) | 100(74-130) | 101(73-133) | 0.88 |
| Mean arterial pressure (mmHg), [Median, IQR] | 76(52-89) | 71(51-89) | 72(39-90) | 0.98 |
| Glasgow Coma Scale≤8, n. (%) | 35 (18) | 21(13) | 14(31) | 0.01 |
| Oxygenation, n. (%) | 88 (44) | 64(42) | 24(54) | 0.60 |
| Altered mental status, n. (%) | 58(29) | 44(28) | 14(31) | 0.86 |
| AVPU score, n. (%) | ||||
| Alert | 100(51) | 88(58) | 12(27) | <0.01 |
| Verbal | 41(21) | 29(19) | 12(27) | 0.29 |
| Pain | 32(16) | 22(14) | 10(23) | 0.06 |
| Unresponsive | 23(12) | 13(9) | 10(23) | 0.02 |
Table 3
Median and IQR of the probability of death using the APACHE II score, NEWS, and REMS
| Total (n=196) | Survivor group (n=152) | Non-survivor group (n=44) | p-value | |
|---|---|---|---|---|
| APACHE II Median, IQR] | 21(15-26) | 19(14-24) | 25(21-31) | <0.01 |
| NEWS [Median, IQR] | 7(6-9) | 7(5-9) | 9(7-10) | <0.01 |
| REMS [Median, IQR] | 9(6-12) | 9(6-11) | 11(8-13) | <0.01 |
Table 4
Comparison of the predictive power and clinical utility of the APACHE II score, NEWS, and REMS in 28-day mortality
| Optimal cut-off | Sensitivity | Specificity | PPV | NPV | PLR | NLR | |||
|---|---|---|---|---|---|---|---|---|---|
| APACHE II | 0.76 (0.67 | -0.83) | 18 | 0.89 | 0.50 | 0.34 | 0.94 | 2.52 | 0.45 |
| NEWS | 0.67 (0.59-0.75) | 0.10 | 7 | 0.70 | 0.62 | 0.35 | 0.88 | 1.84 | 0.76 |
| REMS | 0.70 (0.61-0.78) | 0.26 | 11 | 0.47 | 0.81 | 0.42 | 0.84 | 0.95 | 0.65 |
[i] Abbreviations: APACHE-II, Acute Physiology And Chronic Health Evaluation II; EWS, Early Warning Score; NEWS, National early warning score; REMS, Rapid emergency medicine score; PPV, Positive predictive value; NPV, Negative predictive value; PLR, Positive likelihood ratio; NLR, Negative likelihood ratio; AUC, area under the curve; CI, confidence interval
Fig. 2
Area under the receiver operator (ROC) for National Early Warning Score (NEWS), Rapid Emergency Medical Score and the Acute Physiology and Chronic Health Evaluation (APACHE) II score, calculated at the MET activation