{"title":"Assessment value of the modified early warning score for long-term prognosis of older patients with chronic heart failure.","authors":"Yin Yin, Jie Chen, Shijiu Jiang","doi":"10.5830/CVJA-2023-003","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>The aim of the study was to explore the assessment value of the modified early warning score (MEWS) for the long-term prognosis of older patients with chronic heart failure (CHF).</p><p><strong>Methods: </strong>A total of 180 CHF patients, treated from January 2016 to January 2018, were divided into a grade I group (<i>n</i> = 28), a grade II group (<i>n</i> = 37), a grade III group (<i>n</i> = 68) and a grade IV group (<i>n</i> = 47) according to the New York Heart Association (NYHA) functional classification. The MEWS was compared on admission and discharge. Based on the clinical outcomes during follow up, the patients were divided into a non-survival group (<i>n</i> = 48) and a survival group (<i>n</i> = 132). Their general clinical data and the MEWS were compared. The predictive values of the MEWS, troponin I (cTnI) and B-type natriuretic (BNP) peptide for long-term prognosis were assessed using receiver operator characteristic (ROC) curves.</p><p><strong>Results: </strong>The MEWS on patient discharge was significantly lower than that on admission, and it increased with increasing NYHA grade (<i>p</i> < 0.05). The MEWS in the non-survival group was significantly higher than that in the survival group. Different clinical outcomes were positively correlated with NYHA grade, MEWS, six-minute walking distance and left ventricular ejection fraction (<i>r</i> = 0.368, <i>r</i> = 0.471, <i>r</i> = 0.387, <i>r</i> = 0.423, <i>p</i> < 0.05), and negatively correlated with cTnI and BNP (<i>r</i> = -0.411, <i>r</i> = -0.425). The area under the ROC curve of the MEWS was 0.852, indicating higher accuracy. The optimal cut-off value, sensitivity and specificity of the MEWS for determining prognosis were 5.6, 0.854 and 0.797 points, respectively.</p><p><strong>Conclusion: </strong>The MEWS rose with increasing NYHA grade and reflected the severity of CHF in older patients, which has higher predictive value for long-term prognosis.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Journal of Africa","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5830/CVJA-2023-003","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/28 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: The aim of the study was to explore the assessment value of the modified early warning score (MEWS) for the long-term prognosis of older patients with chronic heart failure (CHF).
Methods: A total of 180 CHF patients, treated from January 2016 to January 2018, were divided into a grade I group (n = 28), a grade II group (n = 37), a grade III group (n = 68) and a grade IV group (n = 47) according to the New York Heart Association (NYHA) functional classification. The MEWS was compared on admission and discharge. Based on the clinical outcomes during follow up, the patients were divided into a non-survival group (n = 48) and a survival group (n = 132). Their general clinical data and the MEWS were compared. The predictive values of the MEWS, troponin I (cTnI) and B-type natriuretic (BNP) peptide for long-term prognosis were assessed using receiver operator characteristic (ROC) curves.
Results: The MEWS on patient discharge was significantly lower than that on admission, and it increased with increasing NYHA grade (p < 0.05). The MEWS in the non-survival group was significantly higher than that in the survival group. Different clinical outcomes were positively correlated with NYHA grade, MEWS, six-minute walking distance and left ventricular ejection fraction (r = 0.368, r = 0.471, r = 0.387, r = 0.423, p < 0.05), and negatively correlated with cTnI and BNP (r = -0.411, r = -0.425). The area under the ROC curve of the MEWS was 0.852, indicating higher accuracy. The optimal cut-off value, sensitivity and specificity of the MEWS for determining prognosis were 5.6, 0.854 and 0.797 points, respectively.
Conclusion: The MEWS rose with increasing NYHA grade and reflected the severity of CHF in older patients, which has higher predictive value for long-term prognosis.
期刊介绍：
The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
