R S Nannan Panday1, T C Minderhoud1, N Alam1, P W B Nanayakkara2. 1. Section Acute Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands. 2. Section Acute Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: p.nanayakkara@vumc.nl.
Abstract
BACKGROUND: A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). METHODS: A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017. Two reviewers independently screened all potentially relevant titles and abstracts for eligibility. RESULTS: 42 studies were included. 36 studies reported on mortality as an endpoint, 13 reported ICU admission and 9 reported the composite outcome of mortality and ICU admission. For mortality prediction National Early Warning Score (NEWS) was the most accurate score in the general ED population and in those with respiratory distress, Mortality in Emergency Department Sepsis score (MEDS) had the best accuracy in patients with an infection or sepsis. ICU admission was best predicted with NEWS, however in patients with an infection or sepsis Modified Early Warning Score (MEWS) yielded better results for this outcome. CONCLUSION: MEWS and NEWS generally had favourable results in the ED and AMU for all endpoints. Many studies have been performed on ED and AMU populations using heterogeneous prognostic scores. However, future studies should concentrate on a simple and easy to use prognostic score such as NEWS with the aim of introducing this throughout the (pre-hospital and hospital) acute care chain.
BACKGROUND: A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). METHODS: A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017. Two reviewers independently screened all potentially relevant titles and abstracts for eligibility. RESULTS: 42 studies were included. 36 studies reported on mortality as an endpoint, 13 reported ICU admission and 9 reported the composite outcome of mortality and ICU admission. For mortality prediction National Early Warning Score (NEWS) was the most accurate score in the general ED population and in those with respiratory distress, Mortality in Emergency Department Sepsis score (MEDS) had the best accuracy in patients with an infection or sepsis. ICU admission was best predicted with NEWS, however in patients with an infection or sepsis Modified Early Warning Score (MEWS) yielded better results for this outcome. CONCLUSION: MEWS and NEWS generally had favourable results in the ED and AMU for all endpoints. Many studies have been performed on ED and AMU populations using heterogeneous prognostic scores. However, future studies should concentrate on a simple and easy to use prognostic score such as NEWS with the aim of introducing this throughout the (pre-hospital and hospital) acute care chain.
Authors: Chieh-Liang Wu; Chen-Tsung Kuo; Sou-Jen Shih; Jung-Chen Chen; Ying-Chih Lo; Hsiu-Hui Yu; Ming-De Huang; Wayne Huey-Herng Sheu; Shih-An Liu Journal: Int J Environ Res Public Health Date: 2021-04-25 Impact factor: 3.390
Authors: Vincent X Liu; Yun Lu; Kyle A Carey; Emily R Gilbert; Majid Afshar; Mary Akel; Nirav S Shah; John Dolan; Christopher Winslow; Patricia Kipnis; Dana P Edelson; Gabriel J Escobar; Matthew M Churpek Journal: JAMA Netw Open Date: 2020-05-01
Authors: Vincent M Quinten; Matijs van Meurs; Tycho J Olgers; Judith M Vonk; Jack J M Ligtenberg; Jan C Ter Maaten Journal: Scand J Trauma Resusc Emerg Med Date: 2018-07-13 Impact factor: 2.953