A physiologically‐based early warning score for ward patients: the association between score and outcome*

TLDR

We analysed physiological values and early warning scores from 1,047 ward patients assessed by an intensive care outreach service, including those referred directly from wards and routine follow‑ups. Greater numbers of physiological abnormalities and higher early warning scores were associated with increased hospital mortality and a higher likelihood of critical‑care admission or treatment limitation, with mortality rising from 4.0 % with no abnormalities to 51.9 % with five or more and 30.3 % of patients scoring above one requiring intervention.

Abstract

We analysed the physiological values and early warning score obtained from 1047 ward patients assessed by an intensive care outreach service. Patients were either referred directly from the wards (n = 245, 23.4%) or were routine critical care follow-ups. Decisions were made to admit 135 patients (12.9%) to a critical care area and limit treatment in another 78 (7.4%). An increasing number of physiological abnormalities was associated with higher hospital mortality (p < 0.0001) ranging from 4.0% with no abnormalities to 51.9% with five or more. An increasing early warning score was associated with more intervention (p < 0.0001) and higher hospital mortality (p < 0.0001). For patients with scores above one (n = 660), decisions to admit to a critical care area or limit treatment were taken in 200 (30.3%). Scores of all physiological variables except temperature contributed to the need for intervention and all variables except temperature and heart rate were associated with hospital mortality.