Conference Abstract | Volume 8, Abstract ELIC2025399 (Oral 025) | Published: 14 Aug 2025
Pristar Oshiozuwe Omogbai1,2, Mojeed Olaitan Rafiu2,3,&, Osahon Otaigbe4, Patience Osifo1,2, Amajuoritse Mercy Owolabi1,2, Ogechi Getrude Chijioke1,2, Joseph Okoeguale2, Ruthmary Obasanmi1,2, Enerembhagbe Efua1,2, Bright Ojeaga1,2, Martha Okonofua1, Osahogie Isaac Edeawe2, Christian Ehigbor Erohubie2,3, Gloria Eifediyi2, Kelly Ohis Iraoyah2,3, Ola Chikerendu Egbuta4, Agatha Ilebalumen Okojie1, Sylvanus Akhalufo Okogbenin2,5, Peter Odion Okokhere2,3, Reuben Agbons Eifediyi2,5, George Obozokhale Akpede2,6
1Nursing Department, Irrua Specialist Teaching Hospital (ISTH), Irrua, Edo State, Nigeria, 2Institute of Viral and Emergent Pathogens Control and Research, Irrua, Edo State, Nigeria, 3Department of Medicine, Irrua Specialist Teaching Hospital (ISTH), Irrua, Edo State, Nigeria, 4Department of Public Health, Irrua Specialist Teaching Hospital (ISTH), Irrua, Edo State, Nigeria, 5Department of Obstetrics and Gynaecology, Irrua Specialist Teaching Hospital (ISTH), Irrua, Edo State, Nigeria, 6Department of Paediatrics, Irrua Specialist Teaching Hospital (ISTH)
&Corresponding author: Dr Mojeed Olaitan Raafiu, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria, Email: raphymoj2012@gmail.com
Received: 24 Mar 2025, Accepted: 09 Jul 2025, Published: 14 Aug 2025
Domain: Infectious Disease Epidemiology
Keywords: MEWS, ISTH, Lassa fever, Nursing
©Pristar Oshiozuwe Omogbai et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Pristar Oshiozuwe Omogbai et al., Predictive value of the modified early warning score for mortality and intensive care unit admission in Lassa fever patients: A retrospective analysis. Journal of Interventional Epidemiology and Public Health. 2025;8(Conf Proc 5):00025. https://doi.org/10.37432/JIEPH-CONFPRO5-00025
Early identification of clinical deterioration in Lassa fever is critical for improving patient outcomes. The Modified Early Warning Score (MEWS) is a simple bedside tool based on physiological parameters. This study evaluated the predictive value of MEWS for mortality and ICU admission among patients with Lassa fever.
We conducted a retrospective analysis of 128 patients admitted with confirmed Lassa fever between March 2023 and February 2024. MEWS was computed from recorded vital signs at admission. Receiver Operating Characteristic (ROC) analysis was used to determine optimal cut-off values for predicting in-hospital mortality and ICU admission. Logistic regression models were applied to assess the association between categorized MEWS and clinical outcomes.
The MEWS ranged from 0 to 10 with a median of 2 and an interquartile range of 1-3.5. During admission, 12 patients (9.4%) died, and 19 (14.8%) required ICU admission. For mortality, the optimal MEWS threshold was ≥3, yielding a sensitivity of 75% and specificity of 80%. The area under the ROC curve (AUC) was 0.81 (95%CI: 0.66–0.96). Logistic regression showed a significant association between elevated MEWS and mortality. Patients with MEWS ≥3 had nearly 10 times the odds of dying compared to those with MEWS <3 (OR=9.9; 95%CI: 2.1–47.3; p=0.004). For ICU admission, the optimal MEWS threshold was ≥2 (sensitivity:68%, specificity:67%), with an AUC of 0.70 (95%CI: 0.58–0.82). The association between MEWS ≥2 and ICU admission was borderline significant (OR=3.1; 95%CI: 1.0–9.8; p=0.060).
MEWS at admission may be useful for identifying Lassa fever patients at higher risk of mortality. A threshold of ≥3 was predictive of in-hospital death. Its utility for predicting ICU admission is less clear and requires further validation. Integrating MEWS into routine triage protocols may aid early risk stratification and improve clinical decision-making.
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