Abstract:Objective To explore the efficacy and optimal timepoint of modified early warning score(MEWS),vitalPACTM early warning score(ViEWS) and national early warning score(NEWS) on predicting the occurrence of inhospital cardiac arrest(IHCA) in patients with acute coronary syndrome (ACS).Methods A total of 172 patients with ACS occured IHCA within 24 hours treated from January 2015 to December 2018 were selected as IHCA group.While 516 patients with ACS who did not develop IHCA was randomly selected as nonIHCA group at a ratio of 1[DK]∶3.The clinical manifestations at 1,2,4,8 and 16 h before IHCA in IHCA group and those at corresponding time points in nonIHCA group were recorded,and the scores of MEWS,ViEWS and NEWS were compared between two groups.The ROC curve was used to evaluate the efficacy of MEWS,ViEWS and NEWS systems in predicting the occurrence of IHCA.Results The scores of MEWS,ViEWS,and NEWS in IHCA group were significantly higher than those in nonIHCA group at each time point before IHCA(P<0.01).At 1,2,4,8 and 16 h before IHCA,AUC of ViEWS in predicting IHCA was higher than those of MEWS and NEWS,suggesting that ViEWS was the most effective predictor of IHCA.At 1,2 and 4h before IHCA,AUC of ViEWS in predicting IHCA was 0.81,0.79 and 0.78 respectively,and all of them were more than 0.7,indicating that the prediction efficiency was moderate.There were no significant differences in AUC of ViEWS in predicting IHCA at 1,2 and 4h before IHCA(P>0.05).Conclusion Compared with MEWS and NEWS systems,ViEWS can effectively predict the occurrence of IHCA in ACS patients 4 hours ahead of time.