Predictive value of modified early warning score in identifying high-risk postoperative patients following abdominal surgery

Darshan Patel; Ojas Patel; Divyang Dave; Hardik Astik; Varun Joshi; Nipun Bansal; Shraddha Patel

doi:10.18203/2349-2902.isj20253019

Authors

Darshan Patel Department of Surgery, Government Medical College, and New civil hospital Surat, Gujarat, India
Ojas Patel Department of Surgery, Government Medical College, and New civil hospital Surat, Gujarat, India https://orcid.org/0009-0000-4079-4608
Divyang Dave Department of Surgery, Government Medical College, and New civil hospital Surat, Gujarat, India
Hardik Astik Department of Surgery, Government Medical College, and New civil hospital Surat, Gujarat, India
Varun Joshi Department of Surgery, Government Medical College, and New civil hospital Surat, Gujarat, India
Nipun Bansal Department of Surgery, Government Medical College, and New civil hospital Surat, Gujarat, India
Shraddha Patel Department of Surgery, Government Medical College, and New civil hospital Surat, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20253019

Keywords:

Modified early warning score, Exploratory laparotomy, Postoperative complications, Mortality prediction

Abstract

Background: Modified Early Warning Score (MEWS) is an objective bedside tool for detecting early physiological deterioration and guiding timely intervention. Its predictive role in postoperative general surgical patients, particularly after exploratory laparotomy, is underexplored in developing countries.

Methods: A prospective observational study was conducted from July 2019 to June 2020 in a tertiary care center. A total of 150 patients undergoing exploratory laparotomy were included. MEWS was calculated using six parameters respiratory rate, systolic blood pressure, heart rate, temperature, urine output and consciousness level at 6-hour intervals postoperatively. Patients were categorized into low-risk (0-2), intermediate-risk (3-4) and high-risk (≥5) groups. Outcomes analyzed included ICU admission and mortality.

Results: The mean age of patients was 41.8 years; 50.7% were male. Emergency surgeries constituted 58.7% of cases. MEWS≥5 was present in 23.4% of patients. All six deaths occurred in patients with MEWS≥7 (p<0.001). ICU admission was significantly associated with higher MEWS. MEWS showed strong predictive accuracy for morbidity and mortality in postoperative patients.

Conclusions: MEWS is a simple, inexpensive and effective tool for early detection of postoperative deterioration and prioritizing ICU transfer. Higher MEWS strongly correlated with mortality and adverse outcomes.

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