Predictive value of early warning scores in in-hospital mortality of patients readmitted to the surgical intensive care unit after major abdominal surgery

Abstract

Background/aims: Early warning scores are simple scores obtained by measuring physiological parameters and have been regarded as useful tools for detecting clinical deterioration. This study aimed to evaluate the impact of early warning scores in predicting in-hospital mortality in critically ill patients readmitted to the surgical intensive care unit.

Methods: The study was conducted at a tertiary referral teaching hospital in South Korea. A total of 161 patients who underwent major abdominal surgery were readmitted to the surgical intensive care unit during hospitalization. To clarify the predictors of mortality in patients after surgical intensive care unit readmission, clinical data, including the 3 types of early warning scores at the time of deterioration before readmission, were analyzed.

Results: The incidence of readmission to the surgical intensive care unit was 6.0%, and the mean duration between the first discharge from the surgical intensive care unit and readmission was 11.2 days. Of the 161 patients, 58 (36.0%) died in hospital. In the multivariate analyses, a higher Modified Early Warning Score at readmission was independently associated with 30-day and in-hospital mortality. The receiver operating characteristic curve of Modified Early Warning Score at readmission demonstrated fair predictive power for 30-day (area under the curve = 0.709) and in-hospital (area under the curve = 0.697) mortality in patients readmitted to the surgical intensive care unit after major abdominal surgery.

Conclusions: The Modified Early Warning Score at readmission is associated with mortality in critically ill patients readmitted to the surgical intensive care unit and can be an independent predictor of both 30-day and in-hospital mortality.