AIM To assess the performance and clinical relevance of the Early Warning Scoring(EWS)system at the Intermediate Care Unit(IMCU).METHODS This cohort study used all the Vital PAC EWS(Vi EWS)scores collected during each...AIM To assess the performance and clinical relevance of the Early Warning Scoring(EWS)system at the Intermediate Care Unit(IMCU).METHODS This cohort study used all the Vital PAC EWS(Vi EWS)scores collected during each nursing shift from 2014through 2016 at the mixed surgical IMCU of an academic teaching hospital.Clinical deterioration defined as transfer to the Intensive Care Unit(ICU)or mortality within 24 h was the primary outcome of interest.RESULTS A total of 9113 aggregated Vi EWS scores were obtained from 2113 admissions.The incidence of the combined outcome was 272(3.0%).The area under the curve of the Vi EWS was 0.72(CI:0.69-0.75).Using a threshold value of six,the sensitivity was 68%with a positive predictive value of 5%and a number needed to trigger(e.g.,false alarms)of 19%.CONCLUSION The Vi EWS at the IMCU has a discriminative performance that is considerably lower than at the hospital ward.The number of false alarms is high,which may result in alarm fatigue.Therefore,use of the Vi EWS in its current form at the IMCU should be reconsidered.展开更多
文摘AIM To assess the performance and clinical relevance of the Early Warning Scoring(EWS)system at the Intermediate Care Unit(IMCU).METHODS This cohort study used all the Vital PAC EWS(Vi EWS)scores collected during each nursing shift from 2014through 2016 at the mixed surgical IMCU of an academic teaching hospital.Clinical deterioration defined as transfer to the Intensive Care Unit(ICU)or mortality within 24 h was the primary outcome of interest.RESULTS A total of 9113 aggregated Vi EWS scores were obtained from 2113 admissions.The incidence of the combined outcome was 272(3.0%).The area under the curve of the Vi EWS was 0.72(CI:0.69-0.75).Using a threshold value of six,the sensitivity was 68%with a positive predictive value of 5%and a number needed to trigger(e.g.,false alarms)of 19%.CONCLUSION The Vi EWS at the IMCU has a discriminative performance that is considerably lower than at the hospital ward.The number of false alarms is high,which may result in alarm fatigue.Therefore,use of the Vi EWS in its current form at the IMCU should be reconsidered.
