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{
    "pk": 14711,
    "title": "Evaluation of the Initial General Ward Early Warning Score and ICU Admission, Hospital Length of Stay and Mortality",
    "subtitle": null,
    "abstract": "Introduction:\n Despite widespread implementation of the Early Warning Score (EWS) in hospitals, its effect on patient outcomes remains mostly unknown. We aimed to evaluate associations between the initial EWS and in-hospital mortality, intensive care unit (ICU) admission, and hospital length of stay (LOS). \nMethods:\n We performed a retrospective cohort study of adult patients admitted to a general hospital ward between July 1, 2014–December 31, 2017. Data were obtained from electronic health records (EHR). The primary outcome was in-hospital mortality. Secondary outcomes were ICU admission and hospital LOS. We categorized patients into three risk groups (low, medium or high risk of clinical deterioration) based on EWS. Descriptive analyses were used.\nResults:\n After applying inclusion and exclusion criteria, we included 53,180 patients for analysis. We found that the initial (low- vs high-risk) EWS was associated with an increased in-hospital mortality (1.5% vs 25.3%, P <0.001), an increased ICU admission rate (3.1% vs 17.6%, P <0.001), and an extended hospital LOS (4.0 days vs 8.0 days, P <0.001).\nConclusion:\n Our findings suggest that an initial high-risk EWS in patients admitted to a general hospital ward was associated with an increased risk of in-hospital mortality, ICU admission, and prolonged hospital LOS. Close monitoring and precise documentation of the EWS in the EHR may facilitate predicting poor outcomes in individual hospitalized patients and help to identify patients for whom timely and adequate management may improve outcomes.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Early Warning Score"
        },
        {
            "word": "screening"
        },
        {
            "word": "monitoring"
        },
        {
            "word": "Prognosis"
        },
        {
            "word": "Hospital Mortality"
        },
        {
            "word": "intensive care unit"
        }
    ],
    "section": "Health Outcomes",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/86h1f302",
    "frozenauthors": [
        {
            "first_name": "Anneke",
            "middle_name": "",
            "last_name": "Gielen",
            "name_suffix": "",
            "institution": "Gelderse Vallei Hospital, Department of Intensive Care Medicine, Ede, The Netherlands",
            "department": "None"
        },
        {
            "first_name": "Kristine",
            "middle_name": "",
            "last_name": "Koekkoek",
            "name_suffix": "",
            "institution": "Gelderse Vallei Hospital, Department of Intensive Care Medicine, Ede, The Netherlands",
            "department": "None"
        },
        {
            "first_name": "Marijke",
            "middle_name": "",
            "last_name": "van der Steen",
            "name_suffix": "",
            "institution": "Gelderse Vallei Hospital, Department of Intensive Care Medicine, Ede, The Netherlands",
            "department": "None"
        },
        {
            "first_name": "Martijn",
            "middle_name": "",
            "last_name": "Looijen",
            "name_suffix": "",
            "institution": "Gelderse Vallei Hospital, Department of Information Technology and Datawarehouse, Ede, Netherlands",
            "department": "None"
        },
        {
            "first_name": "Arthur",
            "middle_name": "R.H.",
            "last_name": "Van Zanten",
            "name_suffix": "",
            "institution": "Gelderse Vallei Hospital, Department of Intensive Care Medicine, Ede, The Netherlands; Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands",
            "department": "None"
        }
    ],
    "date_submitted": "2020-11-03T01:04:56+03:00",
    "date_accepted": "2020-11-03T01:04:56+03:00",
    "date_published": "2021-09-03T03:09:15+03:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14711/galley/7492/download/"
        }
    ]
}