Objective To compare the predictive effect of the Modified Early Warning Score (MEWS) and the National Early Warning Score (NEWS) on the unplanned transfer of patients from emergency observation room to emergency room.

Methods A retrospective analysis was performed for 333 patients in the emergency observation room, including 47 cases who were unplanned transferred to the emergency room. Among 47 patients transferred to the emergency room, 37 patients with NEWS≥3 were included in abnormal NEWS group, and 24 patients with MEWS≥2 were included in abnormal MEWS group. General data, MEWS, NEWS and deterioration condition of vital organs during transfer to the emergency room were recorded. After 72 h of observation, receiver operating characteristic (ROC) curve was drawn according to the outcome of patients, and the predictive value of the two scoring systems for unplanned transfer from emergency observation room to emergency room was compared, and the difference of the predictive value of the two scoring systems for the deterioration of vital organs was further analyzed.

Results There were statistically significant differences in age, albumin level, MEWS and NEWS between two groups (P < 0.05). ROC curve results showed that the area under the curve (AUC) of NEWS was 0.86, the optimum cut-off value scored 3, the sensitivity was 0.83, and the specificity was 0.77. AUC of MEWS was 0.78, the optimum cut-off value scored 2, the sensitivity was 0.77, and the specificity was 0.75. AUC of two scoring systems in predicting unplanned transfer to the emergency room was compared, and the difference was statistically significant (Z=2.03, P=0.04). There was statistical significance in the proportion of respiratory failure patients between the two groups (P < 0.05).

Conclusion Compared with MEWS, NEWS has a higher value in predicting unplanned transfer from emergency observation room to emergency room, and its advantage may be based on the prediction of respiratory failure.