ViEWS--Towards a national early warning score for detecting adult inpatient deterioration

Resuscitation
David R PrytherchP I Featherstone

Abstract

To develop a validated, paper-based, aggregate weighted track and trigger system (AWTTS) that could serve as a template for a national early warning score (EWS) for the detection of patient deterioration. Using existing knowledge of the relationship between physiological data and adverse clinical outcomes, a thorough review of the literature surrounding EWS and physiology, and a previous detailed analysis of published EWSs, we developed a new paper-based EWS - VitalPAC EWS (ViEWS). We applied ViEWS to a large vital signs database (n=198,755 observation sets) collected from 35,585 consecutive, completed acute medical admissions, and also evaluated the comparative performance of 33 other AWTTSs, for a range of outcomes using the area under the receiver-operating characteristics (AUROC) curve. The AUROC (95% CI) for ViEWS using in-hospital mortality with 24h of the observation set was 0.888 (0.880-0.895). The AUROCs (95% CI) for the 33 other AWTTSs tested using the same outcome ranged from 0.803 (0.792-0.815) to 0.850 (0.841-0.859). ViEWS performed better than the 33 other AWTTSs for all outcomes tested. We have developed a simple AWTTS - ViEWS - designed for paper-based application and demonstrated that its performance for predic...Continue Reading

References

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Citations

Jul 11, 2014·Resuscitation·Santiago Romero-Brufau, Jeanne M Huddleston
Jun 11, 2014·Resuscitation·Gary B Smith, David R Prytherch
Aug 5, 2014·American Journal of Respiratory and Critical Care Medicine·Matthew M ChurpekDana P Edelson
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Jun 4, 2013·BMJ Quality & Safety·Michael Buist, Stella Stevens
Apr 12, 2012·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Charlotte BarfodKai Henrik Wiborg Lange
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Feb 5, 2013·Resuscitation·Daryl JonesDavid Story
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