Journal Mobile

BH Cuthbertson, M Boroujerdi, G Prescott
Journal Issue: 
Volume 40: Issue 1: 2010




Early  warning  scores  (EWS)  are  widely  used  to  allow  early recognition of the deteriorating patient. We aimed to test their ability to predict major deterioration in medical patients.
Two cohorts were prospectively identified who were admitted to an acute medical admissions unit and to the respiratory unit but not admitted to the intensive care unit (ICU): medical-non ICU and respiratory-non ICU groups. Two further cohorts were retrospectively identified that required ICU admission from these units (medical-ICU and respiratory-ICU groups). Discriminant analysis and receiver  operating  characteristic  curves  were  used  to  discriminate  between groups, and time relationships were analysed.
Heart  rate  (HR),  respiratory  rate  (RR)  and  oxygen  saturation  (SaO2) were  significantly  higher  in  the  medical-ICU  group  than  the  medical-non  ICU group and significantly higher in the respiratory-ICU group than in the respiratory-non ICU group. Discriminant functions incorporating HR, RR and SaO2 performed at least as well as existing EWS systems in predicting ICU admission.
Commonly  used  physiological  parameters and existing EWS systems are useful at identifying sick patients. The discriminant functions described here appear to have a role in this setting but require validation in future studies.