title: Daily surveillance with early warning scores help predicthospital mortality in medical wards.
abstract: OBJECTIVE
  To analyze the potency of a modified early warning score (EWS) to help predict hospital mortality when used for surveillance in nonacute medical wards.
  
  
  METHODS
  Patients in internal medicine wards were prospectively recruited. First, highest, and last scores; and mean daily score recordings and values were recorded. Nurses calculated scores for each patient upon admission and every 4 h. The last score was the score before death, discharge, or transfer to another ward. The highest scores in total and for each single parameter were used for analysis.
  
  
  RESULTS
  Fifty-nine percent of 182 recruited patients had recordings eligible for data analysis. Patients admitted from the emergency room had higher mortality rates than patients admitted from outpatient clinics (15% vs. 1.5%; P = 0.01) as well as patients whose first (40% vs. 4.9%; P = 0.033) and highest scores (18.8% vs. 1.3%; P = 0.003) were equal to or more than 3. The first recorded EWS was not predictive for mortality while the maximum score during the admission period was.
  
  
  CONCLUSIONS
  This study underlines the fact that each physiological variable of EWS may not have the same weight in determining the outcome.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Durusu Tanrıöver
authors.affiliation: Medical Intensive Care Unit, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Burçin
authors.initials: B
authors.lastname: Halaçlı
authors.affiliation: Department of Internal Medicine, Private Memorial Hospital, İstanbul, Turkey.
authors.forename: Bilgin
authors.initials: B
authors.lastname: Sait
authors.affiliation: Medical Intensive Care Unit, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Öcal
authors.affiliation: Medical Intensive Care Unit, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Topeli
mesh_terms: D017052:Hospital Mortality; D006760:Hospitalization; D006761:Hospitals
keywords: Acute; admission; early warning score; internal medicine