This retrospective study assessed the effectiveness and impact of implementing a Modified Early Warning System (MEWS) and Rapid Response Team (RRT) for inpatients admitted to the general ward (GW) of a medical center. This study included all inpatients who stayed in GWs from Jan. 2017 to Feb. 2022. We divided inpatients into GW_non-MEWS and GW_MEWS groups according to MEWS and RRT implementation in Aug. 2019. The primary outcome, unexpected deterioration, was defined by unplanned admission to intensive care units. We defined the detection performance and effectiveness of MEWS according to if a warning occurred within 24 h before the unplanned ICU admission. There were 129,039 inpatients included in this study, comprising 58,106 GW_non-MEWS and 71,023 GW_MEWS. The numbers of inpatients who underwent an unplanned ICU admission in GW_non-MEWS and GW_MEWS were 488 (.84%) and 468 (.66%), respectively, indicating that the implementation significantly reduced unexpected deterioration (p < .0001). Besides, 1,551,525 times MEWS assessments were executed for the GW_MEWS. The sensitivity, specificity, positive predicted value, and negative predicted value of the MEWS were 29.9%, 98.7%, 7.09%, and 99.76%, respectively. A total of 1,568 warning signs accurately occurred within the 24 h before an unplanned ICU admission. Among them, 428 (27.3%) met the criteria for automatically calling RRT, and 1,140 signs necessitated the nursing staff to decide if they needed to call RRT. Implementing MEWS and RRT increases nursing staff's monitoring and interventions and reduces unplanned ICU admissions.

这项回顾性研究评估了对医疗中心普通病房 (GW) 住院患者实施改良早期预警系统 (MEWS) 和快速反应小组 (RRT) 的有效性和影响。本研究纳入了2017年1月至2022年2月期间入住GW的所有住院患者。我们根据2019年8月MEWS和RRT的实施情况将住院患者分为GW_非MEWS组和GW _MEWS组。定义了主要结局，即意外恶化意外进入重症监护病房。我们根据非计划入住 ICU 前 24 小时内是否发生警告来定义 MEWS 的检测性能和有效性。本研究共纳入 129,039 名住院患者，其中 58,106 GW_{非 MEWS}患者和 71,023 GW _{MEWS 患者}。在 GW _non-MEWS和 GW _MEWS中接受计划外 ICU 住院的住院患者人数分别为 488 (.84%) 和 468 (.66%)，表明该实施显着减少了意外恶化 (p < .0001)。此外，GW _MEWS还执行了 1,551,525 次 MEWS 评估。 MEWS的敏感性、特异性、阳性预测值和阴性预测值分别为29.9%、98.7%、7.09%和99.76%。在非计划进入 ICU 之前的 24 小时内，总共准确出现了 1,568 个警告信号。其中，428例（27.3%）符合自动呼叫RRT的标准，1,140例迹象需要护理人员决定是否需要呼叫RRT。实施 MEWS 和 RRT 可以加强护理人员的监测和干预，并减少计划外 ICU 入院。