Do different patient populations need different early warning scores? The performance of nine different early warning scores used on acutely ill patients admitted to a low-resource hospital in sub-Saharan Africa

Abstract

BACKGROUND: Early warning scores (EWS) generated in a developed healthcare setting may not perform as well in low-resource settings in sub-Saharan Africa. METHOD: The performance of EWS used in developed world was compared with those generated in low-resource settings in sub-Saharan Africa. RESULTS: When tested on 1,266 acutely ill patients consecutively admitted to a low-resource Ugandan hospital there was no statistical difference in the performance of any of the EWS tested. The performance of all the scores appeared to be improved by the addition of mobility assessment. Although statistically insignificant, the National Early Warning Score with extra points added for impaired mobility had the highest discrimination and sensitivity. CONCLUSION: There were only marginal and no statistical differences in the performance of EWS generated in low- and high-resource healthcare settings in a cohort of unselected acutely ill medical patients admitted to a low-resource hospital in sub-Saharan Africa.