Development and validation of a decision tree early warning score based on routine laboratory test results for the discrimination of hospital mortality in emergency medical admissions

Jarvis, Stuart; Kovacs, Caroline; Badriyah, Tessy; Briggs, Jim; Mohammed, Mohammed A.; Meredith, Paul; Schmidt, Paul E.; Featherstone, Peter I.; Prytherch, David; Smith, Gary B.

doi:10.1016/j.resuscitation.2013.05.018

Cited by 42 publications

(49 citation statements)

References 36 publications

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“…In addition, we previously published a single-center study using demographic, vital sign, and laboratory data to predict cardiac arrest and ICU transfer (16). Finally, several other authors have investigated laboratory values alone or adding specific variables, such as lactate, to previously published vital-sign-based risk scores to improve accuracy over current systems (35)(36)(37)(38). These studies were mostly single-center and did not use other data, such as previous ICU admission, to improve model accuracy.…”

Section: Discussionmentioning

confidence: 99%

Multicenter Development and Validation of a Risk Stratification Tool for Ward Patients

Churpek

Yuen²,

Winslow

et al. 2014

Am J Respir Crit Care Med

213

231

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Section: Discussionmentioning

confidence: 99%

Multicenter Development and Validation of a Risk Stratification Tool for Ward Patients

Churpek

Yuen²,

Winslow

et al. 2014

Am J Respir Crit Care Med

213

231

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“…Some studies have reported that the predictive ability of the NEWS increases on combining several lab-oratory results with the NEWS. 9,[20][21][22] This combination method should also be validated in older patients to improve predictive ability in this patient group.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the NEWS is associated with mortality and intensive care unit admission in patients admitted to the ED. [9][10][11][12] As mentioned above, the NEWS is based on the patient's vital signs. However, in elderly patients, mortality prediction based on vital signs may be difficult because older patients may show subtle changes in vital signs due to a reduced physiological response to physiological stress.…”

Section: Introductionmentioning

confidence: 99%

Use of the National Early Warning Score for predicting in-hospital mortality in older adults admitted to the emergency department

et al. 2020

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Objective The National Early Warning Score (NEWS), based on the patients' vital signs, detects clinical deterioration in critically ill patients and is used to reduce the incidence of in-hospital cardiac arrest. However, although mortality prediction based on vital signs may be difficult in older patients, the effectiveness of the NEWS has not yet been evaluated in this population. This study aimed to test the hypothesis that an elevated NEWS at admission increases the mortality risk in older patients admitted to the emergency department (ED). Methods We conducted a single-center retrospective study, including patients admitted to the ED between November 2016 and February 2017. We included patients aged > 65 years who were admitted to the ED for any medical problem. The NEWS was calculated at the time of ED admission. The primary outcome was in-hospital mortality. Results In total, 3,169 patients were included in this study. Median age was 75 years (interquartile range [IQR], 70 to 80 years), and 1,557 (49.1%) patients were male. The in-hospital mortality rate was 5.1% (161 patients). Median NEWS was higher in non-survivors than in survivors (5 [IQR, 3-8] vs. 1 [IQR, 0-3], P < 0.001). Multivariate logistic analysis showed that the NEWS was associated with in-hospital mortality, after adjusting for other confounders. The area under the curve of the NEWS for predicting in-hospital mortality was 0.820 (95% confidence interval, 0.806 to 0.833). Conclusion Our results show that the NEWS at admission is associated with in-hospital mortality among patients aged > 65 years.

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“…The LEWS was calculated according to the formula devised by Jarvis and colleagues [3]. LEWS ≥4 for males and ≥5 for females was taken as being a 'trigger' as suggested by Jarvis and colleagues [3]. …”

Section: Methodsmentioning

confidence: 99%

“…In our trust, audit has shown that only 20 to 35% of patients trigger the clinical EWS prior to cardiac arrest. Jarvis and colleagues proposed that an EWS based on common laboratory findings can predict patient mortality [3]. The aim of this study, as part of a wider review of cardiac arrests in our hospital, was to determine whether the laboratory early warning score (LEWS) might be of use identifying patients at risk of cardiac arrest in our trust.…”

Section: Introductionmentioning

confidence: 99%

Laboratory early warning score versus clinical early warning score as a predictor of imminent cardiac arrest

2014

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Development and validation of a decision tree early warning score based on routine laboratory test results for the discrimination of hospital mortality in emergency medical admissions

Cited by 42 publications

References 36 publications

Multicenter Development and Validation of a Risk Stratification Tool for Ward Patients

Multicenter Development and Validation of a Risk Stratification Tool for Ward Patients

Use of the National Early Warning Score for predicting in-hospital mortality in older adults admitted to the emergency department

Laboratory early warning score versus clinical early warning score as a predictor of imminent cardiac arrest

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