scholarly journals Modified Early Warning Score (MEWS) Identifies Critical Illness among Ward Patients in a Resource Restricted Setting in Kampala, Uganda: A Prospective Observational Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (3) ◽  
pp. e0151408 ◽  
Author(s):  
Rebecca Kruisselbrink ◽  
Arthur Kwizera ◽  
Mark Crowther ◽  
Alison Fox-Robichaud ◽  
Timothy O'Shea ◽  
...  
Keyword(s):  
Critical Illness ◽  
Observational Study ◽  
Early Warning ◽  
Prospective Observational Study ◽  
Early Warning Score

scholarly journals The Value of Modified Early Warning Score (MEWS) in Surgical In-Patients: A Prospective Observational Study

2006 ◽  
Vol 88 (6) ◽  
pp. 571-575 ◽  
Author(s):  
J Gardner-Thorpe ◽  
N Love ◽  
J Wrightson ◽  
S Walsh ◽  
N Keeling
Keyword(s):  
Risk Management ◽  
Observational Study ◽  
Critically Ill ◽  
Early Warning ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Early Warning Score ◽  
Management Tool ◽  
Quality And Safety ◽  
Surgical Ward

INTRODUCTION The Modified Early Warning Score (MEWS) is a simple, physiological score that may allow improvement in the quality and safety of management provided to surgical ward patients. The primary purpose is to prevent delay in intervention or transfer of critically ill patients. PATIENTS AND METHODS A total of 334 consecutive ward patients were prospectively studied. MEWS were recorded on all patients and the primary end-point was transfer to ITU or HDU. RESULTS Fifty-seven (17%) ward patients triggered the call-out algorithm by scoring four or more on MEWS. Emergency patients were more likely to trigger the system than elective patients. Sixteen (5% of the total) patients were admitted to the ITU or HDU. MEWS with a threshold of four or more was 75% sensitive and 83% specific for patients who required transfer to ITU or HDU. CONCLUSIONS The MEWS in association with a call-out algorithm is a useful and appropriate risk-management tool that should be implemented for all surgical in-patients.

scholarly journals National early warning score (NEWS) and the new alternative SpO2 scale during rapid response team reviews: a prospective observational study

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Joonas Tirkkonen ◽  
Sari Karlsson ◽  
Markus B. Skrifvars
Keyword(s):  
Observational Study ◽  
Early Warning ◽  
Prospective Observational Study ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Early Warning Score ◽  
Hospital Death ◽  
Hospital Patient ◽  
Response Team ◽  
National Early Warning Score

Abstract Background The national early warning score (NEWS) enables early detection of in-hospital patient deterioration and timely activation of hospital’s rapid response team (RRT). NEWS was updated in 2017 to include a separate SpO2 scale for those patients with type II respiratory failure (T2RF). In this study we investigated whether NEWS with and without the new SpO2 scale for the T2RF patients is associated with immediate and in-hospital patient outcomes among the patients actually attended by the RRT. Methods We conducted a two-year prospective observational study including all adult RRT patients without limitations of medical treatment (LOMT) in a large Finnish university associated tertiary level hospital. According to the first vital signs measured by the RRT, we calculated NEWSs for the RRT patients and further utilized the new SpO2 scale for the patients with confirmed T2RF. We used multivariate logistic regression and area under the receiver operating characteristic analyses to test NEWS’s accuracy to predict two distinct outcomes: RRT patient’s I) immediate need for intensive care and/or new LOMT and 2) in-hospital death or discharge with cerebral performance category >2 and/or LOMT. Results The final cohort consisted of 886 RRT patients attended for the first time during their hospitalization. Most common reasons for RRT activation were respiratory (343, 39%) and circulatory (226, 26%) problems. Cohort’s median (Q1, Q3) NEWS at RRT arrival was 8 (5, 10) and remained unchanged if the new SpO2 scale was applied for the 104 patients with confirmed T2RF. Higher NEWS was independently associated with both immediate (OR 1.28; 95% CI 1.22–1.35) and in-hospital (1.15; 1.10–1.21) adverse outcomes. Further, NEWS had fair discrimination for both the immediate (AUROC 0.73; 0.69–0.77) and in-hospital (0.68; 0.64–0.72) outcomes. Utilizing the new SpO2 scale for the patients with confirmed T2RF did not improve the discrimination capability (0.73; 0.69–0.76 and 0.68; 0.64–0.71) for these outcomes, respectively. Conclusions We found that in patients attended by a RRT, the NEWS predicts patient’s hospital outcome with moderate accuracy. We did not find any improvement using the new SpO2 scale in T2RF patients.

scholarly journals Copeptin combined with National Early Warning Score for predicting survival in elderly patients with acute and critical illness

2020 ◽  
Author(s):  
Fan Wang ◽  
Wen An ◽  
Xinchao Zhang
Keyword(s):  
Critical Illness ◽  
Observational Study ◽  
Elderly Patients ◽  
Early Warning ◽  
Predictive Value ◽  
Early Warning Score ◽  
Survival Prediction ◽  
Vasopressin Release ◽  
Risk Of Death ◽  
National Early Warning Score

Abstract Purpose Copeptin, reflecting vasopressin release, as well as the National Early Warning Score (NEWS), reflecting the severity of critical illness, might qualify for survival prediction in elderly patients with acute and critical illness. This prospective observational study aimed at assessing the predictive value of copeptin combined with NEWS on the prognosis of elderly patients with acute and critical illness. Methods We analyzed serum copeptin levels and the NEWS at admission to the emergency department (ED) in a prospective, single-center and observational study comprising 205 elderly patients with acute and critical illness. Death within 30 days after admission to the ED was the primary end point. Results The serum copeptin levels and the NEWS in the non-survivor patients group were higher than those in the survivor group [30.35 (14.20, 38.91) vs 17.53 (13.01, 25.20), P = 0.001 and 9.0 (7.0–10.0) vs 7.0 (6.0–8.0), P = 0.001]. Multivariate logistic regression analysis showed that Copeptin, NEWS and copeptin combined with NEWS were all independent risk factors for 30-day mortality in elderly patients with acute and critical illness. Copeptin, NEWS and copeptin combined with NEWS all performed well in predicting 30-day survival, with area under the ROC curve (AUC) values of 0.766 (95%CI, 0.702–0.822), 0.797 (95%CI, 0.744–0.877) and 0.854 (95%CI, 0.798–0.899) respectively. Using the Z test to compare the areas under the above three curves, copeptin combined with NEWS showed a higher predictive value for 30-day survival (P < 0.05). As we calculated, the optimal cut-off value of copeptin and NEWS using the Youden index were 19.78 pg/ml and 8.5 points respectively. Risk stratification analysis showed that patients with both higher copeptin levels and higher NEWS had the highest risk of death. Conclusions Copeptin combined with NEWS have a stronger predictive power on the prognosis of elderly patients with acute and critical illness, comparing to either factor individually.

scholarly journals Implementing the Bedside Paediatric Early Warning System in a community hospital: A prospective observational study

2011 ◽  
Vol 16 (3) ◽  
pp. e18-e22 ◽  
Author(s):  
Christopher S Parshuram ◽  
Ann Bayliss ◽  
Janette Reimer ◽  
Kristen Middaugh ◽  
Nadeene Blanchard
Keyword(s):  
Observational Study ◽  
Early Warning ◽  
Early Warning System ◽  
Prospective Observational Study ◽  
Community Hospital ◽  
Warning System

scholarly journals Association between National Early Warning Scores in primary care and clinical outcomes: an observational study in UK primary and secondary care

2020 ◽  
Vol 70 (695) ◽  
pp. e374-e380 ◽  
Author(s):  
Lauren J Scott ◽  
Niamh M Redmond ◽  
Alison Tavaré ◽  
Hannah Little ◽  
Seema Srivastava ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Clinical Outcomes ◽  
Early Warning ◽  
Secondary Care ◽  
Early Warning Score ◽  
Medical Review ◽  
News Values ◽  
Process Measures ◽  
Sepsis Diagnosis

BackgroundNHS England has mandated use of the National Early Warning Score (NEWS), more recently NEWS2, in acute settings, and suggested its use in primary care. However, there is reluctance from GPs to adopt NEWS/NEWS2.AimTo assess whether NEWS calculated at the point of GP referral into hospital is associated with outcomes in secondary care.Design and settingAn observational study using routinely collected data from primary and secondary care.MethodNEWS values were prospectively collected for 13 047 GP referrals into acute care between July 2017 and December 2018. NEWS values were examined and multivariate linear and logistic regression used to assess associations with process measures and clinical outcomes.ResultsHigher NEWS values were associated with faster conveyance for patients travelling by ambulance, for example, median 94 minutes (interquartile range [IQR] 69–139) for NEWS ≥7; median 132 minutes, (IQR 84–236) for NEWS = 0 to 2); faster time from hospital arrival to medical review (54 minutes [IQR 25–114] for NEWS ≥7; 78 minutes [IQR 34–158] for NEWS = 0 to 2); as well as increased length of stay (5 days [IQR 2–11] versus 1 day [IQR 0–5]); intensive care unit admissions (2.0% versus 0.5%); sepsis diagnosis (11.7% versus 2.5%); and mortality, for example, 30-day mortality 12.0% versus 4.1% for NEWS ≥7 versus NEWS = 0 to 2, respectively. On average, for patients referred without a NEWS value (NEWS = NR), most clinical outcomes were comparable with patients with NEWS = 3 to 4, but ambulance conveyance time and time to medical review were comparable with patients with NEWS = 0 to 2.ConclusionThis study has demonstrated that higher NEWS values calculated at GP referral into hospital are associated with a faster medical review and poorer clinical outcomes.

scholarly journals Modified Early Warning Score as a predictor of intensive care unit readmission within 48 hours: a retrospective observational study

2020 ◽  
Vol 32 (2) ◽  
Author(s):  
Ahmed Naji Balshi ◽  
Basim Mohammed Huwait ◽  
Alfateh Sayed Nasr Noor ◽  
Abdulrahman Mishaal Alharthy ◽  
Ahmed Fouad Madi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Early Warning ◽  
Early Warning Score ◽  
Retrospective Observational Study ◽  
Intensive Care Unit Readmission
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