A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS)
A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS)
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DOI：
10.1111/j.1365-2044.2011.06896.x
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发表时间：
2012-01-01
期刊：
影响因子：
10.7
通讯作者：
Simons, R.
中科院分区：
文献类型：
--
作者：
Singh, S.;McGlennan, A.;Simons, R.
2003 - 2005年妇幼保健保密调查报告建议在所有产科住院病人中采用经修改的产科早期预警系统，以跟踪产妇的生理参数，并帮助早期识别和治疗严重不适的产妇。我们前瞻性地回顾了676例连续的产科住院病例，查看了他们完成的MEOWS图表中的触发因素和他们的发病率证据记录。根据我们的标准，200例（30%）患者触发，86例（13%）患者发生并发症，包括出血（43%），妊娠高血压疾病（31%）和疑似感染（20%）。MEOWS的敏感性为89%（95%CI 8195%），特异性为79%（95%CI 7682%），阳性预测值为39%（95%CI 3246%），阴性预测值为98%（95%CI 9699%）。在研究期间，没有入住重症监护室、心脏呼吸骤停或死亡。这项研究表明，MEOWS是一个有用的床边工具，预测发病率。触发参数的调整可以提高阳性预测值。
The 20032005 Confidential Enquiry into Maternal and Child Health report recommended the introduction of the modified early obstetric warning system (MEOWS) in all obstetric inpatients to track maternal physiological parameters, and to aid early recognition and treatment of the acutely unwell parturient. We prospectively reviewed 676 consecutive obstetric admissions, looking at their completed MEOWS charts for triggers and their notes for evidence of morbidity. Two hundred patients (30%) triggered and 86 patients (13%) had morbidity according to our criteria, including haemorrhage (43%), hypertensive disease of pregnancy (31%) and suspected infection (20%). The MEOWS was 89% sensitive (95% CI 8195%), 79% specific (95% CI 7682%), with a positive predictive value 39% (95% CI 3246%) and a negative predictive value of 98% (95% CI 9699%). There were no admissions to the intensive care unit, cardio respiratory arrests or deaths during the study period. This study suggests that MEOWS is a useful bedside tool for predicting morbidity. Adjustment of the trigger parameters may improve positive predictive value.