Objective: To validate the Delta Modified Search Out Severity (ΔM-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 ΔM-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 ΔM-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 ΔM-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 ΔM-SOS score had a fair to good performance as a predictive score for clinical deterioration in mechanically ventilated patients.

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

DOI: doi.org/10.35755/jmedassocthai.2021.02.11482

Received 25 May 2020 | Revised 30 September 2020 | Accepted 30 September 2020