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Individualizing and optimizing the use of early warning scores in acute medical care for deteriorating hospitalized patients
- Source :
- Resuscitation. 93
- Publication Year :
- 2014
-
Abstract
- AimWhile early warning scores (EWS) have the potential to identify physiological deterioration in an acute care setting, the implementation of EWS in clinical practice has yet to be fully realized. The primary aim of this study is to identify optimal patient-centered rapid response team (RRT) activation rules using electronic medical records (EMR)-derived Markovian models.MethodsThe setting for the observational cohort study included 38,356 adult general floor patients hospitalized in 2011. The national early warning score (NEWS) was used to measure the patient health condition. Chi-square and Kruskal Wallis tests were used to identify statistically significant subpopulations as a function of the admission type (medical or surgical), frailty as measured by the Braden skin score, and history of prior clinical deterioration (RRT, cardiopulmonary arrest, or unscheduled ICU transfer).ResultsStatistical tests identified 12 statistically significant subpopulations which differed clinically, as measured by length of stay and time to re-admission (P
- Subjects :
- Male
medicine.medical_specialty
Emergency Nursing
Medical care
Cohort Studies
Markovian
Acute care
Early Medical Intervention
Medicine
Electronic Health Records
Humans
Healthcare Failure Mode and Effect Analysis
Deterioration
Rapid response team
Intensive care medicine
Propensity Score
Monitoring, Physiologic
Warning system
business.industry
Kruskal–Wallis one-way analysis of variance
Medical record
Patient Acuity
Middle Aged
Early warning score
Prognosis
United States
Heart Arrest
Hospitalization
Early Diagnosis
Outcome and Process Assessment, Health Care
Emergency
Emergency Medicine
Female
business
Cardiology and Cardiovascular Medicine
Prediction
Delivery of Health Care
Cohort study
Subjects
Details
- ISSN :
- 18731570
- Volume :
- 93
- Database :
- OpenAIRE
- Journal :
- Resuscitation
- Accession number :
- edsair.doi.dedup.....4a1a965c9ea8e857005eddb9ece86595