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Use of Delta Modified Search Out Severity (∆M-SOS) Score for Early Detect Clinical Deterioration in Mechanically Ventilated Patients

Chutima Cheranakhorn MD¹, Tawan Chanchaichujit MD¹, Rabiab Khunpakdee RN¹

Affiliation : ¹ Department of Medicine, Hatyai Hospital, Songkhla, Thailand


Objective : To validate the Delta Modified Search Out Severity (∆M-SOS) score, the predictive score for clinical deterioration in mechanically ventilated patients.
Materials and Methods : The prospective observational study included respiratory failure patients who were admitted to the respiratory care unit (RCU) of Hatyai Hospital, a tertiary care hospital, between August 2019 and February 2020. The ∆M-SOS score, score change from previous, and maximum M-SOS score were obtained. The main outcomes were clinical deterioration such as need for resuscitation, transfer to ICU, CPR, or dead, and 28-day mortality.
Results : Of the 158 enrolled patients, 54 (34%) patients developed clinical deterioration. The 28-day mortality was 33.5%. The area under the curve of the ∆M-SOS score and M-SOS were 0.78 (95% CI 0.71 to 0.86, p<0.001) and 0.85 (95% CI 0.78 to 0.92, p<0.001), respectively. The ∆M-SOS score at cut off 3 had sensitivity 68.5%, specificity 79.8%, positive predictive value (PPV) 63.8%, and negative predictive value (NPV) 83.0%, while the M-SOS score at a cut off score of 6 exhibited sensitivity 74.1%, specificity 83.6%, PPV 70.2%, NPV 84.1%.
Conclusion : The ∆M-SOS score had a fair to good performance as a predictive score for clinical deterioration in mechanically ventilated patients.

Received 25 May 2020 | Revised 30 September 2020 | Accepted 30 September 2020
doi.org/10.35755/jmedassocthai.2021.02.11482

Keywords : Validate, Early warning score, Delta, Detect, Clinical deterioration, Mechanically ventilated patients


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