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Original Research
Online Published: 11 Apr 2022
 


A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department

Salman Naeem, Tamoor Gill, Rahma Fiaz, Almas Ashraf, Muneeba Nasir.


Abstract
Objective: The National Early Warning Score (NEWS) is a system used in many hospitals in the United Kingdom. This study compares the accuracy of NEWS, the Modified Early Warning Score (MEWS) and the Rapid Emergency Medicine Score (REMS) in predicting in-hospital length of stay (LOS) mortality in patients presenting to the emergency department (ED).
Methods: A prospective, observational cohort study was conducted in a tertiary care hospital in Pakistan from October, 2014 to December, 2014 All patients ≥16 years were consecutively sampled over three months, presenting to the ED who met the inclusion criteria. Observations were recorded at triage. NEWS, MEWS and REMS were categorized into low, medium and high for regression analysis and compared using receiver operating curve (ROC) analysis. A multivariable logistic regression (MLR) model was used to identify factors associated with LOS and in-hospital mortality.
Results: In total, 4032 patients were recruited (mean age, 47 ± 17 years); 52% were male. In-hospital mortality was 5%, mean ED and hospital LOS were 0.15 ± 0.36 days and 1.86 ± 4.26 days, respectively. ROC for in-hospital mortality and LOS for NEWS, REMS, and MEWS were 0.79, 0.72, 0.64 and 0.61, 0.59, and 0.53, respectively. Mortality and LOS increased with increasing early warning scores. Medium and high NEWS had a strong association with mortality and LOS, respectively. Age, LOS, medium, and high NEWS were associated with mortality on MLR.
Conclusion: NEWS was a superior scale in predicting LOS and in-hospital mortality in patients presenting to ED as compared to REMS and MEWS.

Key words: NEWS, REMS, MEWS, Pakistan, Emergency Department,


 
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How to Cite this Article
Pubmed Style

Naeem S, Gill T, Fiaz R, Ashraf A, Nasir M. A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department. SAJEM. 2021; 4(2): 3-8. doi:10.5455/sajem.040205

Web Style

Naeem S, Gill T, Fiaz R, Ashraf A, Nasir M. A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department. https://www.sajem.org/?mno=44219 [Access: June 22, 2026]. doi:10.5455/sajem.040205

AMA (American Medical Association) Style

Naeem S, Gill T, Fiaz R, Ashraf A, Nasir M. A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department. SAJEM. 2021; 4(2): 3-8. doi:10.5455/sajem.040205


Vancouver/ICMJE Style

Naeem S, Gill T, Fiaz R, Ashraf A, Nasir M. A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department. SAJEM. (2021), [cited June 22, 2026]; 4(2): 3-8. doi:10.5455/sajem.040205


Harvard Style

Naeem, S., Gill, . T., Fiaz, . R., Ashraf, . A. & Nasir, . M. (2021) A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department. SAJEM, 4 (2), 3-8. doi:10.5455/sajem.040205


Turabian Style

Naeem, Salman, Tamoor Gill, Rahma Fiaz, Almas Ashraf, and Muneeba Nasir. 2021. A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department. South Asian Journal of Emergency Medicine, 4 (2), 3-8. doi:10.5455/sajem.040205


Chicago Style

Naeem, Salman, Tamoor Gill, Rahma Fiaz, Almas Ashraf, and Muneeba Nasir. "A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department." South Asian Journal of Emergency Medicine 4 (2021), 3-8. doi:10.5455/sajem.040205


MLA (The Modern Language Association) Style

Naeem, Salman, Tamoor Gill, Rahma Fiaz, Almas Ashraf, and Muneeba Nasir. "A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department." South Asian Journal of Emergency Medicine 4.2 (2021), 3-8. Print. doi:10.5455/sajem.040205


APA (American Psychological Association) Style

Naeem, S., Gill, . T., Fiaz, . R., Ashraf, . A. & Nasir, . M. (2021) A comparison of accuracy of modified early warning score(MEWS), national early warning score(NEWS)and rapid emergency medicine score(REMS) in predicting length of hospital stay and in-hospital mortality in adults presenting to emergency department. South Asian Journal of Emergency Medicine, 4 (2), 3-8. doi:10.5455/sajem.040205


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