title: A physiologically-based early warning score for ward patients: the association between score and outcome.
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.
authors.affiliation: Anaesthetic Department, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. david.goldhill@rnoh.nhs.uk
authors.forename: D R
authors.initials: DR
authors.lastname: Goldhill
authors.forename: A F
authors.initials: AF
authors.lastname: McNarry
authors.forename: G
authors.initials: G
authors.lastname: Mandersloot
authors.forename: A
authors.initials: A
authors.lastname: McGinley
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001831:Body Temperature; D003422:Critical Care; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D018579:Patient Selection; D010362:Patients' Rooms; D011379:Prognosis; D012720:Severity of Illness Index