MODIFIED EARLY WARNING SCORE IN PREDICTING CLINICAL OUTCOMES AMONG ADULT INPATIENTS IN RESOURCE-LIMITED HOSPITALS IN CAMEROON: A MULTICENTRE CROSS-SECTIONAL STUDY
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Keywords
Modified Early Warning Score; Clinical deterioration; Intensive care; Mortality; Critical illness; Cameroon; Resource-limited settings
Abstract
Background: Early recognition of clinical deterioration remains a major challenge in low-resource healthcare settings where intensive care services are limited. The Modified Early Warning Score (MEWS) is a simple bedside tool based on physiological parameters that may facilitate early identification of critically ill patients. This study assessed the effectiveness of MEWS in predicting clinical outcomes among adult inpatients in hospitals in Bamenda, Cameroon.
Methods: A multicentre cross-sectional analytical study was conducted in four hospitals in Bamenda, Cameroon. A total of 330 patients admitted to medical and surgical wards were enrolled. Vital signs including systolic blood pressure, heart rate, respiratory rate, temperature, and level of consciousness were monitored and used to calculate MEWS. Clinical outcomes assessed included discharge home improved, unplanned intensive care unit (ICU) admission, initiation of higher-level care, and mortality. Associations between MEWS and outcomes were evaluated using chi-square tests and logistic regression analyses.
Results: Forty-seven patients (14.2%) had a MEWS ≥5. Patients with infectious diseases were significantly more likely to develop critical MEWS scores than those with non-infectious diseases (16.7% vs. 12.6%, p=0.029). Among patients with MEWS ≥5, 51.1% experienced an unfavourable outcome. Compared with patients whose MEWS was <5, those with MEWS ≥5 had substantially higher odds of mortality (OR=33.65; 95% CI: 6.42–1276.31), ICU admission (OR=11.22; 95% CI: 3.85–32.67), and initiation of higher-level care (OR=7.48; 95% CI: 3.02–18.52), all p<0.001.
Conclusions: MEWS effectively predicts adverse clinical outcomes among ward patients in resource-limited hospitals. Routine implementation of MEWS may facilitate early identification of deteriorating patients and improve clinical decision-making where critical care resources are scarce.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Jude Balan
Department of Nursing Sciences, Ebonyi State University, Abakaliki
Peace Njideka Iheanacho
Department of Nursing Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria
Constance Okoh
Ebonyi State University, Abakaliki
Madu Obiageli
Department of Nursing Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria
Udunma Olive Chijioke
Department of Health Administration and Management Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria
Nneka Ubochi
Department of Nursing Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria
Maranatha Anudu
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria
Echezona Nelson Dominic Ekechukwu
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Occupational and Environmental Health Unit, Institute of Public Health, College of Medicine, University of Nigeria, LANCET Physiotherapy, Wellness, and Research Centre, Enugu, Nigeria.
