RT Journal Article SR Electronic T1 Modified early warning score predicts the need for hospital admission and inhospital mortality JF Emergency Medicine Journal JO Emerg Med J FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine SP 674 OP 678 DO 10.1136/emj.2007.057661 VO 25 IS 10 A1 V C Burch A1 G Tarr A1 C Morroni YR 2008 UL http://emj.bmj.com/content/25/10/674.abstract AB Background: The modified early warning score (MEWS) is a useful tool for identifying hospitalised patients in need of a higher level of care and those at risk of inhospital death. Use of the MEWS as a triage tool to identify patients needing hospital admission and those at increased risk of inhospital death has been evaluated only to a limited extent.Aim: To evaluate the use of the MEWS as a triage tool to identify medical patients presenting to the emergency department who require admission to hospital and are at increased risk of inhospital death.Methods: Physiological parameters were collected from 790 medical patients presenting to the emergency department of a public hospital in Cape Town, South Africa. MEW scores were calculated from the data and multivariate regression analysis was performed to identify independent predictors of hospital admission and inhospital mortality.Results: The proportion of patients admitted and those who died in hospital increased significantly as the MEW score increased (p<0.001). Multivariate regression analysis identified five independent predictors of hospital admission: systolic blood pressure ⩽100 mm Hg, pulse rate ⩾130 beats per minute, respiratory rate ⩾30 breaths per minute, temperature ⩾38.5°C and an impaired level of consciousness. Independent predictors of inhospital death were: abnormal systolic blood pressure (⩽100 or ⩾200 mm Hg), respiratory rate ⩾30 breaths per minute and an impaired level of consciousness.Conclusion: The MEWS, specifically five selected parameters, may be used as a rapid, simple triage method to identify medical patients in need of hospital admission and those at increased risk of inhospital death.