Prediction of in-hospital mortality and length of stay using an early warning scoring system: clinical audit
Prediction of in-hospital mortality and length of stay using an early warning scoring system: clinical audit
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DOI：
10.7861/clinmedicine.6-3-281
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发表时间：
2006-05-01
影响因子：
4.4
通讯作者：
Bell, D.
中科院分区：
文献类型：
--
作者：
Paterson, R.;MacLeod, D. C.;Bell, D.
这项研究的目的是评估引入标准化早期预警评分系统(SEWS)对非选择性急性入院患者在护理切入点的生理观察和患者结局的影响。在两个不同的11天期间，对848名住进内外科综合评估单元的患者进行了连续的临床审计。记录生理参数(呼吸频率、血氧饱和度、体温、血压、心率和意识水平)、住院死亡率、住院时间、转到重症监护中心和工作人员满意度。对这些生理参数的记录有所改善(P<；0.001-0.005)，但血氧饱和度除外(P=0.069)。入院早期预警评分与住院死亡率(P<；0.001)和住院时间(P=0.001)相关。引入评分系统后，住院死亡率下降(P=0.046)。工作人员对问卷的回答表明，评分系统提高了对疾病严重性的认识(80%)，并促使更早的干预(60%)。标准化的早期预警评分系统改进了生理参数的记录，与住院死亡率相关，并有助于预测住院时间。
This aim of this study was to assess the impact of the introduction of a standardised early warning scoring system (SEWS) on physiological observations and patient outcomes in unselected acute admissions at point of entry to care. A sequential clinical audit was performed on 848 patients admitted to a combined medical and surgical assessment unit during two separate 11-day periods. Physiological parameters (respiratory rate, oxygen saturation, temperature, blood pressure, heart rate, and conscious level), in-hospital mortality, length of stay, transfer to critical care and staff satisfaction were documented. Documentation of these physiological parameters improved (P < 0.001-0.005) with the exception of oxygen saturation (P=0.069). The admission early warning score correlated both with in-hospital mortality (P < 0.001) and length of stay (P=0.001). Following the introduction of the scoring system, inpatient mortality decreased (P=0.046). Staff responding to a questionnaire indicated that the scoring system increased awareness of illness severity (80%) and prompted earlier interventions (60%). A standardised early warning scoring system improves documentation of physiological parameters, correlates with in-hospital mortality, and helps predict length of stay.