Journal Mobile

Author(s): 
BH Cuthbertson, M Boroujerdi, G Prescott
Journal Issue: 
Volume 40: Issue 1: 2010

Format

Abstract

 

Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.

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