Can early warning scores identify deteriorating patients in pre-hospital settings? A systematic review

Resuscitation
Rita PatelP Whiting

Abstract

To evaluate the effectiveness and predictive accuracy of early warning scores (EWS) to predict deteriorating patients in pre-hospital settings. Systematic review. Seven databases searched to August 2017. Study quality was assessed using QUADAS-2. A narrative synthesis is presented. Studies that evaluated EWS predictive accuracy or that compared outcomes in populations that did or did not use EWS, in any pre-hospital setting were eligible for inclusion. EWS were included if they aggregated three or more physiological parameters. Seventeen studies (157,878 participants) of predictive accuracy were included (16 in ambulance service and 1 in nursing home). AUCs ranged from 0.50 (CI not reported) to 0.89 (95%CI 0.82, 0.96). AUCs were generally higher (>0.80) for prediction of mortality within short time frames or for combination outcomes that included mortality and ICU admission. Few patients with low scores died at any time point. Patients with high scores were at risk of deterioration. Results were less clear for intermediate thresholds (≥4 or 5). Five studies were judged at low or unclear risk of bias, all others were judged at high risk of bias. Very low and high EWS are able to discriminate between patients who are not likely a...Continue Reading

Citations

Jun 6, 2019·British Journal of Community Nursing·Linda Nazarko
Dec 10, 2019·Age and Ageing·Robert Oliver BarkerBarbara Hanratty
Jun 19, 2019·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Daniel J LaneDamon C Scales
Aug 25, 2020·Journal of Medical Internet Research·Anna V SilvenYk Onno Teng
May 31, 2020·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Jani PaulinTimo Iirola
Aug 22, 2020·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Francisco Martín-RodríguezRaúl López-Izquierdo
Jan 11, 2019·Internal and Emergency Medicine·Francisco Martín-RodríguezRaúl López-Izquierdo
Oct 5, 2019·European Heart Journal. Quality of Care & Clinical Outcomes·Charles D DeakinJacob Ellery
Apr 10, 2020·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Anne PullyblankUNKNOWN West of England Patient Safety Collaborative
Dec 14, 2019·PloS One·Douglas SpanglerHans Blomberg
Mar 1, 2020·International Journal of Environmental Research and Public Health·Francisco Martín-RodríguezJosé Luis Martín-Conty
Apr 8, 2020·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Lauren J ScottAnne Pullyblank
Sep 16, 2020·Critical Care Medicine·Stephanie Sibley, David M Maslove
Oct 23, 2020·JMIR Public Health and Surveillance·Angier AllenRitankar Das
Oct 24, 2020·International Journal of Clinical Practice·Raúl López-IzquierdoCarlos Del Pozo Vegas
Mar 16, 2021·British Journal of Community Nursing·Marina Maciver
Mar 21, 2021·Best Practice & Research. Clinical Anaesthesiology·Santiago García-Del-ValleJuan Ignacio Gómez-Arnau
Mar 15, 2020·Heart & Lung : the Journal of Critical Care·Francisco Martín-RodríguezMiguel A Castro-Villamor
Apr 3, 2021·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Brian M ClemencyLawrence H Brown
Apr 14, 2021·JAMA Network Open·Francisco Martín-RodríguezAncor Sanz-García
Oct 18, 2020·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Ming-Ju HsiehMatthew Huei-Ming Ma
Jul 6, 2021·The American Journal of Emergency Medicine·Francisco Martín-RodríguezRaúl López-Izquierdo
Aug 4, 2021·British Journal of Community Nursing·Anne-Marie Phillips
Oct 11, 2021·BMC Emergency Medicine·Jani PaulinTimo Iirola
Dec 1, 2021·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Francisco Martín-RodríguezRaúl López-Izquierdo

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