Alternative Title介護施設入所者の肺炎入院における個人ごとのバイタルサインの基準域を用いたModified Early Warning Score (MEWS)の有用性 :National Early Waring Score (NEWS)との比較
Periodical titleActa Medica Nagasakiensia
Degree grantor/typeNagasaki University (長崎大学)
Note (General)Aim: The purpose of this study was to compare the usefulness between the National Early Warning Score (NEWS), which uses the absolute value range, and the Modified Early Warning Score (MEWS), which considers individual-specific ranges (evaluated by mean and standard deviation [SD], relative measures), in predicting pneumonia hospitalization among nursing home residents.Methods: The current study was a retrospective, observational study. The subjects were 235 nursing home residents (75 men and 160 women; pneumonia group, n=62; non-pneumonia group, n=173). The mean and SD of each vital sign (systolic blood pressure, heart rate, body temperature, and oxygen saturation) of each subject recorded over 28 days was calculated. In the pneumonia group, the points at the date of hospitalization were aggregated to derive the NEWS and MEWS. In the non-pneumonia group, the point at the 35th day from the start of the nursing home stay was aggregated to derive the NEWS and MEWS.Results: The area under the curve (AUC) for predicting pneumonia hospitalization was 0.80 (95% confidence interval [CI], 0.72- 0.88) for NEWS and 0.92 (95%CI, 0.87-0.97) for MEWS using individual-specific ranges. The AUC of MEWS using individualspecific ranges was significantly greater than that of NEWS (p<0.0001). When 3 was used as a cutoff value in MEWS, the Youden Index was the best value (0.75). Sensitivity, pecificity, positive predictive value, and negative predictive value were 0.77, 0.97, 0.91, and 0.92, respectively.Conclusion: Our MEWS system using individual-specific ranges showed good performance in predicting hospitalization for pneumonia among nursing home residents.
長崎大学学位論文 学位記番号:共博(医歯薬)甲第22号 学位授与年月日:令和4年3月18日
Author: Maeta Shunsuke, Mizukami Satoshi, Tomita Yoshihito, Date Yutaka, Arima Kazuhiko, Aoyagi Kiyoshi
Citation: Acta Medica Nagasakiensia , 65(3), pp.89−94; 2022
identifier:Nagasaki University (長崎大学), 博士(医学) (2022-03-18)
http://hdl.handle.net/10069/00000041454
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2022-05-09T11:57:37+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション