Application of Modified Early Warning Score in Patients with Hypertensive Intracerebral Hemorrhage After Neurosurgery.

BACKGROUND

Hypertensive intracerebral hemorrhage (HICH) is one of serious complications of hypertension. Therefore, early identification of postoperative deterioration of patients and timely intervention measures are needed.

OBJECTIVE

To evaluate the application of Modified Early Warning Score (MEWS) in HICH patients after neurosurgery.

DESIGN

Retrospective study.

PARTICIPANTS

82 HICH patients admitted to the neurosurgery department of our hospital from July 2022 to January 2023 were enrolled as subjects.

INTERVENTIONS: The MEWS score and the early warning score of postoperative deterioration of HICH patients were evaluated every hour. The respiratory rate, heart rate, systolic blood pressure, and blood oxygen saturation were monitored by a bedside multi-parameter monitor. The consciousness was evaluated by the Glasgow Coma Scale (GCS) score.

PRIMARY OUTCOME MEASURES: The receiver operator characteristic (ROC) curve was drawn to compare the predictive effect of the early warning scale and the MEWS on the prognosis of postoperative deterioration in patients with HICH.

RESULTS

The area under the ROC curve of early warning score predicted the postoperative deterioration of patients to be 0.9660, the best cutoff value was 3.9 points, the sensitivity was 98.35%, the specificity was 86.67%, and the Yoden index was 0.784. The area under the ROC curve of the MEWS for postoperative deterioration of HICH patients was 0.869, the best cutoff value was 3.9, the sensitivity was 83.33%, the specificity was 71.67%, and the Yoden index was 0.517. However, unlike early warning scoring scale, MEWS score was only used to evaluate vital signs with high frequency of clinical monitoring, and the threshold range of heart rate, systolic blood pressure and consciousness score set was not fully applicable to patients after HICH.

CONCLUSION

The early warning scoring scale for postoperative deterioration of HICH patients has good predictive efficacy and strong operability.