Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers / 中南大学学报(医学版)

OBJECTIVES@#Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model.@*METHODS@#The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention.@*RESULTS@#The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful.@*CONCLUSIONS@#Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.

Gender measurement invariance of the Perceived Social Support Scale in people aged 50 years and older / 中华老年医学杂志

Objective:To investigate gender measurement invariance of the Perceived Social Support Scale(PSSS)in people aged 50 years and older.Methods:A total of 1013 adults(50-96 years old)in Beijing, Hunan and Shandong were tested by using PSSS.The measurement invariance of PSSS between middle-aged and elderly males and females was analyzed.Differences in PSSS total scores and subscale scores between males and females were examined.Results:The equivalence test results of each item in the questionnaire met the requirements of the metrology(△CFI≥0.010, △TLI≥0.010, △RSMEA≤0.015), indicating that the hypotheses of morphological equivalence, weak equivalence, strong equivalence and strict equivalence of PSSS were all valid in the middle-aged and elderly population regardless of gender.In addition, middle-aged and elderly females had higher scores in family support, support from friends, support from other people and perceived social support than their male counterparts( P<0.05). Conclusions:PSSS has cross-gender equivalence in middle-aged and elderly people.Thus, differences in PSSS can reflect the perceived social support level in middle-aged and elderly people of different genders.

Effect of fluoxetine intervention on clinical efficacy and neurological function rehabilitation in patients with depression after cerebral infarction / 中国基层医药

Objective@#To analyze the clinical effect of fluoxetine in the treatment of patients with post-cerebral infarction depression (PSD) and its influence on neurological rehabilitation.@*Methods@#From February 2017 to February 2018, 92 PSD patients received treatment in the department of neurology of the Third People's Hospital of Quzhou were included in the study.The patients were randomly divided into two groups according to the digital table, with 46 cases in each group.The control group was treated with specialist symptomatic therapy, while the study group was treated with fluoxetine intervention for 4 weeks.The Hamilton anxiety scale (HAMD), neurological deficit scale (NIHSS) and daily living capacity scale (ADL) were used to evaluate the clinical effects of the two groups, and the adverse reactions of the two groups were observed.@*Results@#One week before treatment, the HAMD, NIHSS and ADL scores of the study group were (28.37±2.18)points, (23.10±3.16)points and (40.61±3.52)points, respectively, which of the control group were (28.30±2.24)points, (22.91±3.20)points and (41.15±3.35)points, respectively, there were no statistically significant differences between the two groups (t=0.223, 1.522, 0.761, all P>0.05). After 2 weeks of treatment, the HAMD, NIHSS and ADL scores of the study group were (21.08±2.33)points, (19.27±2.89)points and (49.26±2.88)points, respectively, which were higher than those of the control group[(24.15±2.43)points, (21.16±2.18)points, (44.26±2.54)points](t=4.384, 10.216, 8.276, all P<0.05). After 4 weeks of treatment, the HAMD, NIHSS and ADL scores of the study group were (12.61±1.87)points, (10.12±1.30)points, (70.13±2.16)points, respectively, which were higher than those of the control group[(15.20±2.06)points, (17.45±2.66)points, (51.19±2.46)points](t=7.273, 18.283, 5.371, all P<0.05). The total effective rate of neurological recovery in the study group was 91.30%(42/46), the total effective rate of depression treatment was 84.78%(39/46), which in the control group were 76.09%(35/46) and 65.22%(30/46), respectively, the differences were statistically significant (χ2=3.903, 4.696, all P<0.05).@*Conclusion@#The application of fluoxetine in the treatment of PSD can effectively improve the patients' depressive symptoms, promote the recovery of neurological function, improve self-care ability, and has high safety.It has important clinical value.

Timing of the laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for acute pyogenic cholecystitis in the advanced age / 国际外科学杂志

Objective@#To investigate the timing of the laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for acute pyogenic cholecystitis in the advanced age.@*Methods@#The clinical data for 56 advanced age patients with acute pyogenic cholecystitis in the Department of Hepatobiliary Surgery, the 900th Hospital of the Joint Logistics Support Force of People′s Liberation Army from January 2018 to February 2019 were retrospectively analyzed. There were 31 males and 25 females, aged from 70 to 86 years, with average age was (75.52±3.57) years. According to the percutaneous transhepatic gallbladder drainage(PTGD) after laparoscopic cholecystectomy(LC) time interval, all patients were divided into three groups. Patients in the group A(n=12), B(n=21), and C (n=23) performed LC were within 2 months, during 2-4 months, and during 4-6 months, retrospectively. Observation indicators: (1) Surgical situations. The operation and postoperative basic condition of the three groups were compared. (2) Follow-up situations. Patients were followed-up by outpatient examination or telephone interview to detect the postoperative complication in the postoperative three months up to June 2019. Measurement data with normal distribution were represented as (Mean±SD), and comparison multiple groups was done using single factor analysis of variance (AVONA test) , and comparison between groups was done using the t test, and comparison of multiple groups in pairs was done using the SNK-q test, and hierarchical data were analyzed using Kruskal-wallis H test. Count data were analyzed using the chi-square test or Fisher exact probability.@*Results@#(1) Surgical situations: the thickness of gallbladder wall before LC, the rates of converting to laparotomy, the volume of intraoperative blood loss, the operation duration, and the duration of postoperative hospital stay were (0.57±0.04) cm, 50.0%, (95.83±11.45) ml, (107.50±21.90) min, (5.67±3.40) d in the group A, and (0.43±0.03) cm, 9.5%, (69.52±24.59) ml, (71.43±12.16) min, (3.76±2.61) d in the group B, and (0.43±0.05) cm, 39.1%, (68.64±21.89) ml, (77.95±12.88) min, (5.05±2.95) d in the group C, respectively, showing significant differences in the above indicators between the three groups (P<0.05). The thickness of gallbladder wall before LC, the volume of intraoperative blood loss, the operation duration, those in group A were higher than the group B and C (P<0.05), and with no statistically significant different between the group B and C (P>0.05). The rates of converting to laparotomy, the duration of postoperative hospital stay in group B were better than the group A and C (P<0.05), and with no statistically significant different between the group A and C (P>0.05). The thickness of gallbladder wall before LC, the volume of intraoperative blood loss, the operation duration, and the duration of postoperative hospital stay were (0.43±0.03) cm, (46.67±9.82) ml, (67.69±7.77) min, (2.64±0.58) d in the gallbladder wall thickness of successful LC patients, and (0.52±0.04) cm, (123.53±17.30) ml, (134.12±25.51) min, (8.47±0.80) d in the laparotomy patients, respectively, showing significant differences in the above indicators between the two groups (P<0.05). (2) Follow-up situations: 56 patients were followed up and without perioperative death. No complications occurred after 3 months of follow-up.@*Conclusion@#Elective surgery that is performed in 2-4 months after PTGD for patients with acute pyogenic cholecystitis in the advanced age can reduce the volume of intraoperative blood loss and the rates of converting to laparotomy, shorten the operation duration and the duration of postoperative hospital stay, which is beneficial to the recovery of patients.

Timing of the laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for acute pyogenic cholecystitis in the advanced age / 国际外科学杂志

Objective To investigate the timing of the laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for acute pyogenic cholecystitis in the advanced age.Methods The clinical data for 56 advanced age patients with acute pyogenic cholecystitis in the Department of Hepatobiliary Surgery,the 900th Hospital of the Joint Logistics Support Force of People's Liberation Army from January 2018 to February 2019 were retrospectively analyzed.There were 31 males and 25 females,aged from 70 to 86 years,with average age was (75.52±3.57) years.According to the percutaneous transhepatic gallbladder drainage(PTGD) after laparoscopic cholecystectomy(LC) time interval,all patients were divided into three groups.Patients in the group A(n =12),B (n =21),and C (n =23) performed LC were within 2 months,during 2-4 months,and during 4-6 months,retrospectively.Observation indicators:(1) Surgical situations.The operation and postoperative basic condition of the three groups were compared.(2) Follow-up situations.Patients were followed-up by outpatient examination or telephone interview to detect the postoperative complication in the postoperative three months up to June 2019.Measurement data with normal distribution were represented as (Mean ± SD),and comparison multiple groups was done using single factor analysis of variance (AVONA test),and comparison between groups was done using the t test,and comparison of multiple groups in pairs was done using the SNK-q test,and hierarchical data were analyzed using Kruskal-wallis H test.Count data were analyzed using the chi-square test or Fisher exact probability.Results (1) Surgical situations:the thickness of gallbladder wall before LC,the rates of converting to laparotomy,the volume of intraoperative blood loss,the operation duration,and the duration of postoperative hospital stay were (0.57±:0.04) cm,50.0％,(95.83 ±11.45) ml,(107.50±21.90) min,(5.67±3.40) d in the group A,and (0.43 ±0.03) cm,9.5％,(69.52±24.59) ml,(71.43 ±12.16) min,(3.76±2.61) d in the group B,and (0.43 ± 0.05) cm,39.1％,(68.64 ±21.89) ml,(77.95 ±12.88) min,(5.05 ±2.95) d in the group C,respectively,showing significant differences in the above indicators between the three groups (P ＜ 0.05).The thickness of gallbladder wall before LC,the volume of intraoperative blood loss,the operation duration,those in group A were higher than the group B and C (P ＜0.05),and with no statistically significant different between the group B and C (P ＞ 0.05).The rates of converting to laparotomy,the duration of postoperative hospital stay in group B were better than the group A and C (P ＜ 0.05),and with no statistically significant different between the group A and C (P ＞0.05).The thickness of gallbladder wall before LC,the volume of intraoperative blood loss,the operation duration,and the duration of postoperative hospital stay were (0.43 ± 0.03) cm,(46.67 ± 9.82) ml,(67.69 ± 7.77) min,(2.64 ±0.58) d in the gallbladder wall thickness of successful LC patients,and (0.52±0.04) cm,(123.53 ±17.30) ml,(134.12±25.51) min,(8.47 ±0.80) d in the laparotomy patients,respectively,showing significant differences in the above indicators between the two groups (P ＜ 0.05).(2) Follow-up situations:56 patients were followed up and without perioperative death.No complications occurred after 3 months of follow-up.Conclusion Elective surgery that is performed in 2-4 months after PTGD for patients with acute pyogenic cholecystitis in the advanced age can reduce the volume of intraoperative blood loss and the rates of converting to laparotomy,shorten the operation duration and the duration of postoperative hospital stay,which is beneficial to the recovery of patients.

Effect of fluoxetine intervention on clinical efficacy and neurological function rehabilitation in patients with depression after cerebral infarction / 中国基层医药

Objective To analyze the clinical effect of fluoxetine in the treatment of patients with post-cerebral infarction depression ( PSD) and its influence on neurological rehabilitation.Methods From February 2017 to February 2018,92 PSD patients received treatment in the department of neurology of the Third People ＇s Hospital of Quzhou were included in the study.The patients were randomly divided into two groups according to the digital table , with 46 cases in each group.The control group was treated with specialist symptomatic therapy ,while the study group was treated with fluoxetine intervention for 4 weeks.The Hamilton anxiety scale (HAMD),neurological deficit scale (NIHSS) and daily living capacity scale (ADL) were used to evaluate the clinical effects of the two groups ,and the adverse reactions of the two groups were observed.Results One week before treatment,the HAMD,NIHSS and ADL scores of the study group were (28.37 ±2.18)points,(23.10 ±3.16)points and (40.61 ±3.52)points,respectively, which of the control group were (28.30 ±2.24)points,(22.91 ±3.20)points and (41.15 ±3.35)points,respectively, there were no statistically significant differences between the two groups (t＝0.223,1.522,0.761,all P＞0.05). After 2 weeks of treatment ,the HAMD,NIHSS and ADL scores of the study group were (21.08 ±2.33) points, (19.27 ±2.89) points and (49.26 ±2.88) points,respectively,which were higher than those of the control group [(24.15 ±2.43)points,(21.16 ±2.18)points,(44.26 ±2.54)points](t＝4.384,10.216,8.276,all P＜0.05). After 4 weeks of treatment ,the HAMD,NIHSS and ADL scores of the study group were (12.61 ±1.87) points, (10.12 ±1.30 ) points, (70.13 ±2.16) points, respectively, which were higher than those of the control group [(15.20 ±2.06)points,(17.45 ±2.66)points,(51.19 ±2.46)points](t＝7.273,18.283,5.371,all P＜0.05). The total effective rate of neurological recovery in the study group was 91.30%(42／46),the total effective rate of depression treatment was 84.78%(39／46),which in the control group were 76.09%(35／46) and 65.22%(30／46),respectively,the differences were statistically significant (χ2 ＝3.903,4.696,all P＜0.05).Conclusion The application of fluoxetine in the treatment of PSD can effectively improve the patients ＇depressive symptoms,promote the recovery of neurological function ,improve self-care ability,and has high safety.It has important clinical value.

Reliability and validity of the Chinese version of Rheumatoid Arthritis Self-Efficacy Scale / 中国实用护理杂志

Objective To translate Rheumatoid Arthritis Self-efficacy Scale (RASE) into Chinese and to evaluate its reliability and validity. Methods A total of 188 hospitalized patients with rheumatoid arthritis (RA) were selected as research subjects through convenience sampling method. According to the translation mode of the scale, Chinesization and cultural adjustment were conducted to the English version of RASEto test reliability and validity. Results Item analysis showed that the Chinese version of RASE could discriminate the high-score group from the low-score group (P<0.01). Pearson correlation analysis showed that the correlation coefficient between the score of each item and the total score of the Chinese version of RASE was positively correlated (P<0.01).Exploratory factor analysis extracted a total of 8 common factors, which explained 68.55％of the total variance. The Cronbachαof the Chinese version of RASE was 0.901, and Cronbachαof each dimension ranged from 0.660 to 0.867;the retest reliability was 0.955 after 1 week, and ranged from 0.819 to 0.984 for each dimension;the split-half reliability coefficient was 0.848. Conclusion The Chinese version of RASE has good reliability and validity, which can be applied to the research of self-efficacy of patients with RA in China.

Resting-state fMRI study of adolescents with conduct disorder: an ALFF analysis / 中华行为医学与脑科学杂志

Objective To investigate the functional characteristic of adolescents with conduct disorder (CD) in the resting state.Methods Resting-sate fMRI (rs-fMRI) scans were administered to 28 male adolescents with CD and 28 age-,gender-and IQ-matched healthy controls (HCs).The rs-fMRI data were subjected to amplitude of low-frequency fluctuation (ALFF) analysis and ALFF values were compared between the two groups.Additionally,the region ROIs showed significant difference and correlation analysis was conducted between ALFF in each ROI and Barratt's scores.Results ① Compared to HCs,the CD group showed decreased ALFF (P＜0.005) bilaterally in the superior frontal gyrus,right middle frontal gyrus,right posterior cingulate gyrus,right inferior parietal lobule (MNI coordinates:-21,48,27;21,24,48;36,24,33 6,-36,39;48,-45,57 respectively) as well as increased ALFF (P＜O.005) in the left thalamus and left lingual gyrus (MNI coordinates:-15,-27,-3;-18,-87,-12 respectively).② There was no significant correlation between ALFF and Barratt's scores in ROIs.Conclusion The results suggest that CD is associated with abnormal intrinsic brain activity,mainly in frontal-parietal-occipital-limbic cortices,which is related to emotional and cognitive processing and behavioral functions.

Grey matter concentration revealed by voxel-based morphometry in individuals with cognitive vulnerability to depression / 中南大学学报(医学版)

Objective:To explore the grey matter concentration in individuals with cognitive vulnerability to depression.Methods:Thirty individuals with cognitive vulnerability to depression and thirty age-and gender-matched healthy controls were enrolled in this study,and they were subjected to magnetic resonance imaging (MRI) examination.The grey matter concentration differences were compared between the two groups by using voxel-based morphometry (VBM) following MRI.Results:Individuals with cognitive vulnerability to depression showed significantly lower grey matter density in bilateral insular,left cerebellum,right supplementary motor area,and left precentral gyrus than those in the healthy controls,while the healthy controls showed significantly lower grey density in the right inferior frontal gyrus,right middle frontal gyrus,and left cuneus than those in the individuals with cognitive vulnerability to depression.Conclusion:Structural brain abnormalities in individuals with cognitive vulnerability to depression might be the neural basis for cognitive vulnerability to depression.

Reference value range of pulse oximetry plethysmographic waveform parameters in the normal adults / 中华急诊医学杂志

Objective To Pulse oximetry saturation has been wildly used clinically.It has been reported that pulse oximetry plethysmographic waveform (POP) reflected the peripheral tissue perfusion.In this study,we parameterized POP,observed the value of POP parameters in normal adults,and established the normal reference value range.Methods A multi-center prospective descriptive study.Total of 1 019 adult volunteers with normovolemia from 7 cities were enrolled in this study.Sex,age,height,weight and pulse oximetry data in awake and spontaneous breathing under in quiet conditions in the room temperature were collected.POP parameters and perfusion index were analyzed using MATLAB 2012a software.The normal reference value ranges of POP parameters,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),were formulated.Results Statistical differences of POP parameters were detected between men and women in the normal adult.The 95％ confidence reference value of POP parameters in normal population was as follows:Amp (104.8-2298.7) PVA and AUC (3265.8-6028.5) PVPGin total,Amp (129.4-2433.6) PVA and AUC (3319.0-5862.2) PVPG in male;Amp (89.5-2138.2) PVA and AUC (3163.9-5929.9) PVPG in female.Conclusions POP,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),had normal reference value ranges in normal adults.

Effect of acupoint hot compress with warming moxibustion bag on radiation proctitis caused by ;radiotherapy in cervical cancer / 中国实用护理杂志

Objective To evaluate the effect of acupointhot compress with warming moxibustion bag on treating radiation proctitis caused by radiotherapy in cervical cancer. Methods 78 patients of cervical cancer with acute radioactive proctitis caused by radiotherapy were divided into two groups according to the length of hospital stays. The experiment group was given compress Tianshu acupoint with warm moxibustion bag every day, along with drug and retention enema, while the control group was treated with drug and retention enema only. Then observe and evaluate the effect of different treatment on each group. Results The total effective rate of treating radiation proctitis in experimental group was 94.44%(34/36) which was superior to 76.19% (32/42) of the control group (χ2=4.962, P<0.05). The influence of tumor radiotherapy in experimental group was also superior to the control group, nine patients were forced to suspend to radiotherapy by (6.11 ± 1.96) days in the control group, while five cases were suspended to radiotherapy by (2.20±1.09) days in the experiment group (t=4.066,P<0.05). Conclusions Acupoint hot compress with warming moxibustion bag combine with retention enema have an advantage over retention enema only on radiation proctitis caused by radiotherapy in cervical cancer.

The role of pulse oximetry plethysmographic waveform monitoring as a marker of restoration of spontaneous circulation:a pilot study / 中华危重病急救医学

ObjectiveTo investigate the feasibility of using pulse oximetry plethysmographic waveform (POP) to identify the restoration of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR).Methods An observational research was conducted. A porcine model of ventricular fibrillation (VF) arrest was reproduced. After 3 minutes of untreated VF, animals received CPR according to the latest CPR guidelines, providing chest compressions to a depth of 5 cm with a rate of 105 compressions per minute and instantaneous mechanical ventilation. After 2 minutes of CPR, animals were defibrillated with 100 J biphasic, followed by continuous chest compressions. Data of hemodynamic parameters, partial pressure of end-tidal carbon dioxide (PETCO2) and POP were collected. The change in POP was observed, and the characteristics of changes of the waves were recorded during the peri-CPR period using the time and frequency domain methods.Results VF was successfully induced in 6 pigs, except 1 death in anesthesia induction period.① After VF, invasive blood pressure waveform and POP of the animals disappeared. PETCO2 was (18.83±2.71) mmHg (1 mmHg=0.133 kPa), and diastolic arterial pressure was (23.83±5.49) mmHg in compression stage. Animals attained ROSC within 1 minute after defibrillation, with PETCO2 [(51.83±9.35) mmHg] and diastolic arterial pressure [(100.67±10.97) mmHg] elevated significantly compared with that of compression stage (t1 = 8.737,t2 = 25.860, bothP = 0.000), with appearance of arterial blood pressure waveform.② Characteristic changes in POP were found in all experimental animals. During the stages of induced VF, compression, ROSC, and compression termination, POP showed characteristic waveform changes. POP showed disappearance of waveform, regular compression wave, fluctuation hybrid and stable pulse wave in time domain method; while in the frequency domain method waveform disappearance, single peak of compression, double or fusion peak and single peak of pulse were observed.Conclusion Analysis of POP using time and frequency domain methods could not only quickly detect cardiac arrest, but also show a role as a feasible, non-invasive marker of ROSC during CPR.

Different brain activity in pons in adolescent males with high-and low-activity MAOA genotype: resting-state fMRI study / 中华行为医学与脑科学杂志

Objective To examine the effects of a functional polymorphism of the monoamine oxidase A (MAOA) gene on spontaneous brain activity in healthy male adolescents.Methods Resting-state fMRI was performed on 31 healthy male adolescents with the low-activity MAOA genotype (MAOA-L) and 25 healthy male adolescents with the high-activity MAOA genotype (MAOA-H).The amplitude of low-frequency fluctuation (ALFF) of the blood oxygen level-dependent (BOLD) signal was calculated using REST software,and was compared between two genotype groups.The region ROIs showed significant difference.The ALFF data in ROIs were related to BIS scores.Results Compared with the MAOA-H group,the MAOA-L group showed a significant decrease of ALFF (P＜0.001) in the pons (MNI coordinates:-6,-19,-23;6,-16,-17;-6,-25,-32).In addition,the BIS scores were positively correlated with ALFF in pons in the MAOA-L group (r=0.398,P=0.02),but not in the MAOA-H group.Conclusions There exists relevance between the polymorphism of MAOA and the spontaneous brain activity in pons.And the lower activity of spontaneous brain activity in pons may be a key risk factor for impulsivity and aggression.

The value of modified early warning score in predicting early mortality of critically ill patients admitted to emergency department / 中华危重病急救医学

ObjectiveTo evaluate the value of modified early warning score (MEWS) in predicting mortality of critically ill patients admitted to emergency department.Methods A prospective cohort study was conducted. Clinical data of emergency patients admitted to resuscitation room of Peking Union Medical College Hospital from Feburary 13rd, 2014 to April 20th, 2014 were collected, and their MEWS were calculated based on medical records and their clinical outcomes was followed. Incidence of primary outcome (3-day mortality) and secondary outcome [all deaths and composite outcome of intensive care unit (ICU) transfer, cardio-pulmonary resuscitation, and death] were compared between MEWS positive (MEWS≥5) or negative (MEWS 0-4) patients, and multi-regression logistic analysis was done to look for the impact factors of primary outcome in these patients.Results 176 patients, among them 98 (55.68%) were male, were enrolled in the study. Their mean age was (56.86±21.46) years old. Mean MEWS was 4.30±2.74. There was 74 cases in MEWS positive group, and 102 in negative group. Primary endpoint occurred in 41 patients, and the 3-days mortality in MEWS positive group was significantly higher than that in MEWS negative group [37.84 (28/74) vs. 12.74% (13/102), odds ratio (OR) = 4.167, 95% confidence interval (95%CI) = 1.973-8.804,P< 0.001]. At the meantime, incidence of all death [54.05% (40/74) vs. 17.65% (18/102),OR = 5.490, 95%CI = 2.770-10.883,P< 0.001] and the incidence of ICU transfer, cardio-pulmonary resuscitation and death [64.86% (48/74) vs. 25.49% (26/102),OR = 5.396, 95%CI = 2.809-10.366,P< 0.001] were also significantly higher in MEWS positive group as compared with negative group. Multi-regression logistic showed abnormal mental status (OR = 3.606, 95%CI = 1.541-8.436,P = 0.003) but not MEWS≥5 (OR = 1.672, 95%CI = 0.622-4.494,P = 0.308)was the predictor of 3-day mortality in emergency admitted critically ill patients.Conclusions Although the incidence of severe adverse events is significantly increased in patients with MEWS≥5 compared with those with MEWS 0-4, MEWS≥5 cannot be an efficient predictor for 3-day mortality. Abnormal mental status shows some predictive value for early mortality in critically ill patients seen in emergency department.