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Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department
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| Zeitschriftentitel: | CJEM |
|---|---|
| Personen und Körperschaften: | , , , , , |
| In: | CJEM, 20, 2018, 2, S. 266-274 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Springer Science and Business Media LLC
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| Schlagwörter: |
| author_facet |
Skitch, Steven Tam, Benjamin Xu, Michael McInnis, Laura Vu, Anthony Fox-Robichaud, Alison Skitch, Steven Tam, Benjamin Xu, Michael McInnis, Laura Vu, Anthony Fox-Robichaud, Alison |
|---|---|
| author |
Skitch, Steven Tam, Benjamin Xu, Michael McInnis, Laura Vu, Anthony Fox-Robichaud, Alison |
| spellingShingle |
Skitch, Steven Tam, Benjamin Xu, Michael McInnis, Laura Vu, Anthony Fox-Robichaud, Alison CJEM Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department Emergency Medicine |
| author_sort |
skitch, steven |
| spelling |
Skitch, Steven Tam, Benjamin Xu, Michael McInnis, Laura Vu, Anthony Fox-Robichaud, Alison 1481-8035 1481-8043 Springer Science and Business Media LLC Emergency Medicine http://dx.doi.org/10.1017/cem.2017.21 <jats:title>ABSTRACT</jats:title><jats:sec id="S1481803517000215_abs1" sec-type="objectives"><jats:title>Objectives</jats:title><jats:p>Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis.</jats:p></jats:sec><jats:sec id="S1481803517000215_abs2" sec-type="methods"><jats:title>Methods</jats:title><jats:p>The study population included admissions to two hospitals over a 6-month period. Cases experienced a critical event defined by unplanned intensive care unit admission, cardiopulmonary resuscitation, or death. Controls were randomly selected from the database in a 2-to-1 ratio to match cases on the burden of comorbid illness. Receiver operating characteristic (ROC) curves were used to evaluate HEWS as a predictor of the likelihood of critical deterioration and sepsis.</jats:p></jats:sec><jats:sec id="S1481803517000215_abs3" sec-type="results"><jats:title>Results</jats:title><jats:p>The sample included 845 patients, of whom 270 experienced a critical event; 89 patients were excluded because of missing vitals. An ROC analysis indicated that HEWS at ED triage had poor discriminative ability for predicting the likelihood of experiencing a critical event 0.62 (95% CI 0.58-0.66). HEWS had a fair discriminative ability for meeting criteria for sepsis 0.77 (95% CI 0.72-0.82) and good discriminative ability for predicting the occurrence of a critical event among septic patients 0.82 (95% CI 0.75-0.90).</jats:p></jats:sec><jats:sec id="S1481803517000215_abs4" sec-type="conclusion"><jats:title>Conclusion</jats:title><jats:p>This study indicates that HEWS at ED triage has limited utility for identifying patients at risk of experiencing a critical event. However, HEWS may allow earlier identification of septic patients. Prospective studies are needed to further delineate the utility of the HEWS to identify septic patients in the ED.</jats:p></jats:sec> Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department CJEM |
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Springer Science and Business Media LLC, 2018 |
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Springer Science and Business Media LLC, 2018 |
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| title |
Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_unstemmed |
Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_full |
Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_fullStr |
Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_full_unstemmed |
Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_short |
Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_sort |
examining the utility of the hamilton early warning scores (hews) at triage: retrospective pilot study in a canadian emergency department |
| topic |
Emergency Medicine |
| url |
http://dx.doi.org/10.1017/cem.2017.21 |
| publishDate |
2018 |
| physical |
266-274 |
| description |
<jats:title>ABSTRACT</jats:title><jats:sec id="S1481803517000215_abs1" sec-type="objectives"><jats:title>Objectives</jats:title><jats:p>Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis.</jats:p></jats:sec><jats:sec id="S1481803517000215_abs2" sec-type="methods"><jats:title>Methods</jats:title><jats:p>The study population included admissions to two hospitals over a 6-month period. Cases experienced a critical event defined by unplanned intensive care unit admission, cardiopulmonary resuscitation, or death. Controls were randomly selected from the database in a 2-to-1 ratio to match cases on the burden of comorbid illness. Receiver operating characteristic (ROC) curves were used to evaluate HEWS as a predictor of the likelihood of critical deterioration and sepsis.</jats:p></jats:sec><jats:sec id="S1481803517000215_abs3" sec-type="results"><jats:title>Results</jats:title><jats:p>The sample included 845 patients, of whom 270 experienced a critical event; 89 patients were excluded because of missing vitals. An ROC analysis indicated that HEWS at ED triage had poor discriminative ability for predicting the likelihood of experiencing a critical event 0.62 (95% CI 0.58-0.66). HEWS had a fair discriminative ability for meeting criteria for sepsis 0.77 (95% CI 0.72-0.82) and good discriminative ability for predicting the occurrence of a critical event among septic patients 0.82 (95% CI 0.75-0.90).</jats:p></jats:sec><jats:sec id="S1481803517000215_abs4" sec-type="conclusion"><jats:title>Conclusion</jats:title><jats:p>This study indicates that HEWS at ED triage has limited utility for identifying patients at risk of experiencing a critical event. However, HEWS may allow earlier identification of septic patients. Prospective studies are needed to further delineate the utility of the HEWS to identify septic patients in the ED.</jats:p></jats:sec> |
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| author | Skitch, Steven, Tam, Benjamin, Xu, Michael, McInnis, Laura, Vu, Anthony, Fox-Robichaud, Alison |
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| description | <jats:title>ABSTRACT</jats:title><jats:sec id="S1481803517000215_abs1" sec-type="objectives"><jats:title>Objectives</jats:title><jats:p>Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis.</jats:p></jats:sec><jats:sec id="S1481803517000215_abs2" sec-type="methods"><jats:title>Methods</jats:title><jats:p>The study population included admissions to two hospitals over a 6-month period. Cases experienced a critical event defined by unplanned intensive care unit admission, cardiopulmonary resuscitation, or death. Controls were randomly selected from the database in a 2-to-1 ratio to match cases on the burden of comorbid illness. Receiver operating characteristic (ROC) curves were used to evaluate HEWS as a predictor of the likelihood of critical deterioration and sepsis.</jats:p></jats:sec><jats:sec id="S1481803517000215_abs3" sec-type="results"><jats:title>Results</jats:title><jats:p>The sample included 845 patients, of whom 270 experienced a critical event; 89 patients were excluded because of missing vitals. An ROC analysis indicated that HEWS at ED triage had poor discriminative ability for predicting the likelihood of experiencing a critical event 0.62 (95% CI 0.58-0.66). HEWS had a fair discriminative ability for meeting criteria for sepsis 0.77 (95% CI 0.72-0.82) and good discriminative ability for predicting the occurrence of a critical event among septic patients 0.82 (95% CI 0.75-0.90).</jats:p></jats:sec><jats:sec id="S1481803517000215_abs4" sec-type="conclusion"><jats:title>Conclusion</jats:title><jats:p>This study indicates that HEWS at ED triage has limited utility for identifying patients at risk of experiencing a critical event. However, HEWS may allow earlier identification of septic patients. Prospective studies are needed to further delineate the utility of the HEWS to identify septic patients in the ED.</jats:p></jats:sec> |
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| spelling | Skitch, Steven Tam, Benjamin Xu, Michael McInnis, Laura Vu, Anthony Fox-Robichaud, Alison 1481-8035 1481-8043 Springer Science and Business Media LLC Emergency Medicine http://dx.doi.org/10.1017/cem.2017.21 <jats:title>ABSTRACT</jats:title><jats:sec id="S1481803517000215_abs1" sec-type="objectives"><jats:title>Objectives</jats:title><jats:p>Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis.</jats:p></jats:sec><jats:sec id="S1481803517000215_abs2" sec-type="methods"><jats:title>Methods</jats:title><jats:p>The study population included admissions to two hospitals over a 6-month period. Cases experienced a critical event defined by unplanned intensive care unit admission, cardiopulmonary resuscitation, or death. Controls were randomly selected from the database in a 2-to-1 ratio to match cases on the burden of comorbid illness. Receiver operating characteristic (ROC) curves were used to evaluate HEWS as a predictor of the likelihood of critical deterioration and sepsis.</jats:p></jats:sec><jats:sec id="S1481803517000215_abs3" sec-type="results"><jats:title>Results</jats:title><jats:p>The sample included 845 patients, of whom 270 experienced a critical event; 89 patients were excluded because of missing vitals. An ROC analysis indicated that HEWS at ED triage had poor discriminative ability for predicting the likelihood of experiencing a critical event 0.62 (95% CI 0.58-0.66). HEWS had a fair discriminative ability for meeting criteria for sepsis 0.77 (95% CI 0.72-0.82) and good discriminative ability for predicting the occurrence of a critical event among septic patients 0.82 (95% CI 0.75-0.90).</jats:p></jats:sec><jats:sec id="S1481803517000215_abs4" sec-type="conclusion"><jats:title>Conclusion</jats:title><jats:p>This study indicates that HEWS at ED triage has limited utility for identifying patients at risk of experiencing a critical event. However, HEWS may allow earlier identification of septic patients. Prospective studies are needed to further delineate the utility of the HEWS to identify septic patients in the ED.</jats:p></jats:sec> Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department CJEM |
| spellingShingle | Skitch, Steven, Tam, Benjamin, Xu, Michael, McInnis, Laura, Vu, Anthony, Fox-Robichaud, Alison, CJEM, Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department, Emergency Medicine |
| title | Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_full | Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_fullStr | Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_full_unstemmed | Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_short | Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| title_sort | examining the utility of the hamilton early warning scores (hews) at triage: retrospective pilot study in a canadian emergency department |
| title_unstemmed | Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department |
| topic | Emergency Medicine |
| url | http://dx.doi.org/10.1017/cem.2017.21 |