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International Journal of Emergency Medicine

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Open Access 01-12-2014 | Original Research

Improving recognition of patients at risk in a Portuguese general hospital: results from a preliminary study on the early warning score

Authors: Nuno Correia, Rui Paulo Rodrigues, Márcia Carvalho Sá, Paula Dias, Luís Lopes, Artur Paiva

Published in: International Journal of Emergency Medicine | Issue 1/2014

Abstract

Background

Early warning score (EWS) is a system that assists in the timely recognition of hospitalized patients outside critical care areas with potential or established critical illness at risk of deteriorating and who may be receiving suboptimal care. No such systems have been implemented in Portuguese National Health Service's wards. We performed a preliminary study to assess the potential outcome of applying the EWS in our hospital setting.

Methods

An observational retrospective study was conducted based on 100 patients assessed by the outreach team due to an acute event. The EWS was calculated a posteriori on three preceding periods from the acute deterioration (−12, −24, and −72 h).

Results

In 35 patients, there was insufficient recording of vital signs. The final sample of 65 patients includes 62.0% men, and the mean age (±SD) was 67 ± 16 years old. Respiratory problems were the main cause of deterioration (44.6%). The EWS score increased from −72 to −12 h. More than half of cases (63.0%) were admitted into high care units, and their mean (±SD) score was higher in comparison to those remaining in general wards (Intermediate Care Units 3.75 ± 1.9, Intensive Care Units 4.2 ± 1.5, wards 3.5 ± 1.4). Score at −24 and −12 h seemed to predict length of stay (LoS; p < 0.05) and mortality, respectively. The EWS would have incremented early medical attention by 40.0% if a threshold of ≥3 was used.

Conclusions

EWS systems are not widely used in Portuguese health service. Our data suggests that the EWS would allow early recognition for a higher number of patients in comparison to current ward care. Clinical worsening, lengths of stay, admission into high care units, and mortality may be predicted by the EWS. Prospective studies with multivariable analysis are needed to clarify the global outcome of the EWS implementation in national wards.

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Title: Improving recognition of patients at risk in a Portuguese general hospital: results from a preliminary study on the early warning score
Authors: Nuno Correia
Rui Paulo Rodrigues
Márcia Carvalho Sá
Paula Dias
Luís Lopes
Artur Paiva
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Emergency Medicine / Issue 1/2014
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI: https://doi.org/10.1186/s12245-014-0022-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Improving recognition of patients at risk in a Portuguese general hospital: results from a preliminary study on the early warning score

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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