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Early AND warning AND score

Hamish R Tomlinson, Marco A F Pimentel, Stephen Gerry, David A Clifton, Lionel Tarassenko, Peter J Watkinson
BACKGROUND: Data smoothing of vital signs has been reported in the anesthesia literature, suggesting that clinical staff are biased toward measurements of normal physiology. However, these findings may be partially explained by clinicians interpolating spurious values from noisy signals and by the undersampling of physiological changes by infrequent manual observations. We explored the phenomenon of data smoothing using a method robust to these effects in a large postoperative dataset including respiratory rate, heart rate, and oxygen saturation (SpO2)...
August 9, 2018: Anesthesia and Analgesia
Joost Dj Plate, Linda M Peelen, Luke Ph Leenen, Falco Hietbrink
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 VitalPAC EWS (ViEWS) scores collected during each nursing shift from 2014 through 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 ViEWS scores were obtained from 2113 admissions...
August 4, 2018: World Journal of Critical Care Medicine
Emmanuel Fru Nsutebu, Ana Belén Ibarz-Pavón, Elizabeth Kanwar, Nancy Prospero, Neil French, Conor McGrath
OBJECTIVE: To evaluate the impact of a collaborative programme for the early recognition and management of patients admitted with sepsis in the northwest of England. SETTING: 14 hospitals in the northwest of England. INTERVENTION: A quality improvement programme (Advancing Quality (AQ) Sepsis) that promoted a sepsis care bundle including time-based recording of early warning scores, documenting systemic inflammatory response syndrome criteria and suspected source of infection, taking of blood cultures, measuring serum lactate levels, administration of intravenous antibiotics, administration of oxygen, fluid resuscitation, measurement of fluid balance and senior review...
August 7, 2018: Postgraduate Medical Journal
Elena Arsevska, Sarah Valentin, Julien Rabatel, Jocelyn de Goër de Hervé, Sylvain Falala, Renaud Lancelot, Mathieu Roche
Since 2013, the French Animal Health Epidemic Intelligence System (in French: Veille Sanitaire Internationale, VSI) has been monitoring signals of the emergence of new and exotic animal infectious diseases worldwide. Once detected, the VSI team verifies the signals and issues early warning reports to French animal health authorities when potential threats to France are detected. To improve detection of signals from online news sources, we designed the Platform for Automated extraction of Disease Information from the web (PADI-web)...
2018: PloS One
Eric Shelov, Naveen Muthu, Heather Wolfe, Danielle Traynor, Nancy Craig, Christopher Bonafide, Vinay Nadkarni, Daniela Davis, Maya Dewan
BACKGROUND AND OBJECTIVE:  Pediatric in-hospital cardiac arrest most commonly occurs in the pediatric intensive care unit (PICU) and is frequently preceded by early warning signs of clinical deterioration. In this study, we describe the implementation and evaluation of criteria to identify high-risk patients from a paper-based checklist into a clinical decision support (CDS) tool in the electronic health record (EHR). MATERIALS AND METHODS:  The validated paper-based tool was first adapted by PICU clinicians and clinical informaticians and then integrated into clinical workflow following best practices for CDS design...
July 2018: Applied Clinical Informatics
Won Gun Kwack, Dong Seon Lee, Hyunju Min, Yun Young Choi, Miae Yun, Youlim Kim, Sang Hoon Lee, Inae Song, Jong Sun Park, Young-Jae Cho, You Hwan Jo, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee
Efforts to detect patient deterioration early have led to the development of early warning score (EWS) models. However, these models are disease-nonspecific and have shown variable accuracy in predicting unexpected critical events. Here, we propose a simpler and more accurate method for predicting risk in respiratory ward patients. This retrospective study analyzed adult patients who were admitted to the respiratory ward and detected using the rapid response system (RRS). Study outcomes included transfer to the intensive care unit (ICU) within 24 hours after RRS activation and in-hospital mortality...
2018: PloS One
Sarah Forster, Gemma Housley, Tricia M McKeever, Dominick E Shaw
OBJECTIVE: Early Warning Scores (EWSs) are used to monitor patients for signs of imminent deterioration. Although used in respiratory disease, EWSs have not been well studied in this population, despite the underlying cardiopulmonary pathophysiology often present. We examined the performance of two scoring systems in patients with respiratory disease. DESIGN: Retrospective cohort analysis of vital signs observations of all patients admitted to a respiratory unit over a 2-year period...
July 30, 2018: BMJ Open
Raziye Gizem Yüksel Gök, Alper Gök, Mehtap Bulut
INTRODUCTION: In this study our purpose is to examine the effectiveness and reliability of MEWS (Modified Early Warning Score), REMS (Rapid Emergency Medicine Score) and WPS (Worthing Physiological Scoring System) scoring systems for prediction of the prognosis and mortality rate of critically ill patients scheduled to be admitted to intensive care unit (ICU) among emergency department (ED) patients. METHODS: This single-centered retrospective study was performed on medical, surgical and trauma patients referred to the ED and admitted to ICU of University Hospital between 23 July 2013 and 26 November 2015...
July 21, 2018: International Emergency Nursing
Antonia Ho, Jane Mallewa, Ingrid Peterson, Miguel SanJoaquin, Shikha Garg, Naor Bar-Zeev, Mavis Menyere, Maaike Alaerts, Gugulethu Mapurisa, Moses Chilombe, Mulinda Nyirenda, David G Lalloo, Camilla Rothe, Marc-Alain Widdowson, Meredith McMorrow, Neil French, Dean Everett, Robert S Heyderman
Data on the epidemiology of severe acute respiratory illness (SARI) in adults from low-income, high human immunodeficiency virus (HIV) prevalence African settings are scarce. We conducted adult SARI surveillance in Blantyre, Malawi. From January 2011 to December 2013, individuals aged ≥ 15 years with SARI (both inpatients and outpatients) were enrolled at a large teaching hospital in Blantyre, Malawi. Nasopharyngeal aspirates were tested for influenza and other respiratory viruses by polymerase chain reaction...
July 23, 2018: American Journal of Tropical Medicine and Hygiene
John Burke, Sally Wood, Andrew Hermon, Tamas Szakmany
BACKGROUND: The Sepsis Six bundle is designed to facilitate early intervention with three diagnostic and three therapeutic steps to be delivered within 1 h to patients with suspected sepsis. AIMS AND OBJECTIVES: To investigate the effects of delivering the 'Sepsis Six' bundle by the Critical Care Outreach team on patient outcomes. DESIGN: In a prospective observational study, all adult patients on the general wards from June 2012 to January 2014 with sepsis who were screened and treated by the Critical Care Outreach team were included...
July 24, 2018: Nursing in Critical Care
Young Seok Lee, Jae Woo Choi, Yeon Hee Park, Chaeuk Chung, Dong Il Park, Jeong Eun Lee, Hye Sun Lee, Jae Young Moon
PURPOSE: To investigate the efficacy of the National Early Warning Score (NEWS) in predicting in-hospital mortality. MATERIALS AND METHODS: This was a retrospective observational study and the electronic medical records of the patients were reviewed based on NEWS at the time of admission. RESULTS: The performance of NEWS was effective in predicting hospital mortality (area under the curve: 0.765; 95% confidence interval: 0.659-0.846). Based on the Kaplan Meier survival curves, the survival time of patients who are at high risk according to NEWS was significantly shorter than that of patients who are at low risk (p < 0...
July 17, 2018: Journal of Critical Care
John Kellett, Martin Otyek Opio
BACKGROUND: low QRS voltage has been shown to be associated with increased mortality in the general population and in a small pilot study the combined QRS voltage of ECG leads I and II was found to be associated with in-hospital mortality AIM: confirm that low QRS voltage predicts the in-hospital mortality of acutely ill patients, and compare QRS voltage with other predictors of mortality that can be easily, quickly and cheaply obtained at the bedside METHODS: prospective observational study of vital signs, QRS voltage and simple tools used to assess mental, functional and nutritional status at the bedside in unselected acutely ill patients admitted to a resource-poor hospital in sub-Saharan Africa...
July 18, 2018: Clinical Cardiology
Radu Postelnicu, Stephen M Pastores, David H Chong, Laura Evans
No abstract text is available yet for this article.
July 7, 2018: Journal of Critical Care
Michael Collins
No abstract text is available yet for this article.
July 12, 2018: British Journal of Nursing: BJN
K M Torsney, R Romero-Ortuno
Parkinson's disease and frailty are both common conditions affecting older people. Little is known regarding the association of the Clinical Frailty Scale with hospital outcomes in idiopathic Parkinson's disease patients admitted to the acute hospital. We aimed to test whether frailty status was an independent predictor of short-term mortality and other hospital outcomes in older inpatients with idiopathic Parkinson's disease. METHOD: We conducted an observational retrospective study in a large tertiary university hospital between October 2014 and October 2016...
June 2018: Journal of the Royal College of Physicians of Edinburgh
C L Downey, J Croft, H Buckley, R Randell, J M Brown, D G Jayne
Background: Despite medical advances, major surgery remains high risk. Up to 44% of patients experience postoperative complications, which can have huge impacts for patients and the healthcare system. Early recognition of postoperative complications is crucial in reducing morbidity and preventing long-term disability. The current standard of care is intermittent manual vital signs monitoring, but new wearable remote monitors offer the benefits of continuous vital signs monitoring without limiting the patient's mobility...
2018: Pilot and Feasibility Studies
Immaculate Nakitende, Teopista Namujwiga, John Kellett, Martin Opio, Alfred Lumala
Background: fever is a common presenting complaint of patients, especially in sub-Saharan Africa. Although most medical authorities consider fever to be synonymous with an elevated body temperature the relationship of the complaint of fever made by patients to temperature has not been well defined. Aim: this study examined the relationship of the complaint of fever to temperature on and after admission and in-hospital mortality. Method: observational study in a low-resource Ugandan mission hospital...
July 6, 2018: QJM: Monthly Journal of the Association of Physicians
Bourke W Tillmann, Michelle L Klingel, Shelley L McLeod, Scott Anderson, Wael Haddara, Neil G Parry
PURPOSE: Early warning scores (EWS) and critical care outreach teams (CCOT) have been developed to respond to decompensating patients. Nevertheless, controversy exists around their effectiveness. The primary objective of this study was to determine if a delay of ≥ 60 min between when a patient was identified as meeting EWS criteria and the CCOT was activated impacted in-hospital mortality. METHODS: This was a historical cohort study evaluating all new CCOT activations over a four-year study period (1 June 2007 to 31 August 2011) for inpatients ≥ 18 yr of age at two academic tertiary care hospitals in London, Ontario, Canada...
July 6, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
C L Duus, E K Aasvang, R M Olsen, H B D Sørensen, L N Jørgensen, M P Achiam, C S Meyhoff
INTRODUCTION: Millions of patients undergo major abdominal surgery worldwide each year, and the post-operative phase carries a high risk of respiratory and circulatory complications. Standard ward observation of patients includes vital sign registration at regular intervals. Patients may deteriorate between measurements, and this may be detected by continuous monitoring. The aim of this study was to compare the number of micro events detected by continuous monitoring to those documented by the widely used standardized Early Warning Score (EWS)...
July 2, 2018: Acta Anaesthesiologica Scandinavica
Zhidong Zhao, Yefei Zhang
For both the acquisition of mobile electrocardiogram (ECG) devices and early warning and diagnosis of clinical work, high-quality ECG signals is particularly important. We describe an effective system which could be deployed as a stand-alone signal quality assessment algorithm for vetting the quality of ECG signals. The proposed ECG quality assessment method is based on the simple heuristic fusion and fuzzy comprehensive evaluation of the SQIs. This method includes two modules, i.e., the quantification and extraction of Signal Quality Indexes (SQIs) for different features, intelligent assessment and classification...
2018: Frontiers in Physiology
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