Use of national early warning score for observation for increased risk for clinical deterioration during post-ICU care at a surgical ward

Pia Katrin Klepstad, Trond Nordseth, Normunds Sikora, Pål Klepstad

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Purpose: Patients transferred from an intensive care unit (ICU) to a general ward are at risk for clinical deterioration. The aim of the study was to determine if an increase in National Early Warning Score (NEWS) value predicted worse outcomes in surgical ward patients previously treated in the ICU. Patients and methods: A retrospective observational study was conducted in a cohort of gastrointestinal surgery patients after transfer from an ICU/high dependency unit (HDU). NEWS values were collected throughout the ward admission. Clinical deterioration was defined by ICU readmission or death. The ability of NEWS to predict clinical deterioration was determined using a linear mixed effect model. Results: We included 124 patients, age 65.9±14.5, 60% males with an ICU Simplified Acute Physiology Score II 33.8±12.7. No patients died unexpectedly at the ward and 20 were readmitted to an ICU/HDU. The NEWS values increased by a mean of 0.15 points per hour (intercept 3.7, P<0.001) before ICU/HDU readmission according to the linear mixed effect model. NEWS at transfer from ICU was the only factor that predicted readmission (OR 1.32; 95% CI 1.01–1.72; P=0.04) at the time of admission to the ward. Conclusion: Clinical deterioration of surgical patients was preceded by an increase in NEWS.

Original languageEnglish
Pages (from-to)315-322
Number of pages8
JournalTherapeutics and Clinical Risk Management
Volume15
DOIs
Publication statusPublished - 2019

Keywords*

  • Clinical deterioration
  • Early warning score
  • Post ICU patients
  • Surgical

Field of Science*

  • 3.3 Health sciences

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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