Objectives: Modified Early Warning Score (MEWS) score is a reliable, safe, instant and inexpensive score, that can be used for prognosticating patients with acute pancreatitis (AP) due to its ability to reflect ongoing changes of the systemic inflammatory response syndrome (SIRS) associated with AP. This study aims to determine an optimal MEWS value in predicting severity in AP and determine its accuracy in doing so. Methods: Patients diagnosed with AP and admitted to a single institution were analyzed to determine value of MEWS in identifying severe AP. The highest MEWS score (hMEWS) for the day and the mean of all the scores of a given day (mMEWS) were determined for each day. Sensitivity, specificity, negative predictive value (NPV), and positive predictive values (PPV) were calculated for the optimal MEWS values obtained. Results: Two hundred patients were included. The data suggested that a hMEWS value >2 on day 1 is most accurate in predicting severe AP, with a specificity of 90.8% and positive predictive value of 83.3%. A mMEWS of >1.2 on day 2 was found to be most accurate in predicting severe AP, with a sensitivity of 81.2%, specificity of 76.6%, PPV of 69.8% and NPV of 85.9%. These were found to be more accurate than previous studies. Conclusions: MEWS provides a novel, easy, instant, repeatable and reliable prognostic score that is comparable, if not superior to existing scoring systems. Its true value however, may lie in it being used in a resource-limited setting such as primary health care centres.

Objectives: Modified Early Warning Score (MEWS) score is a reliable, safe, instant and inexpensive score, that can be used for prognosticating patients with acute pancreatitis (AP) due to its ability to reflect ongoing changes of the systemic inflammatory response syndrome (SIRS) associated with AP....