Early warning score predicts acute mortality in stroke patients

Area of Science:

• Neurology
• Critical Care Medicine
• Clinical Monitoring

Background:

• Clinical deterioration and mortality in acute stroke patients are often preceded by changes in physiological parameters.
• There is a need for systematic tools to identify at-risk patients early for intervention.

Purpose of the Study:

• To evaluate the early warning score (EWS) as a tool for identifying acute stroke patients at risk of deterioration and predicting mortality.
• To assess the prognostic validity of EWS in an acute stroke population.

Main Methods:

• A retrospective cohort study of 274 patients admitted with acute stroke.
• Vital signs were measured upon admission and throughout hospitalization to calculate a composite EWS.
• Prognostic validity was assessed using Area Under the Receiver Operating Characteristics Curve (AUROC) and Kaplan-Meier curves, with 30-day mortality as the outcome.

Main Results:

• The study demonstrated high prognostic performance for EWS at admission (AUROC 0.856) and maximal EWS (AUROC 0.949).
• Mortality rates significantly correlated with EWS, ranging from 2% for EWS 0-1 to 63% for EWS ≥ 5.
• A total of 24 patients (8.8%) died within 30 days.

Conclusions:

• The early warning score (EWS) is a simple, valid tool for identifying patients at high risk of mortality following acute stroke.
• EWS, derived from readily available physiological parameters, can guide clinical decision-making and resource allocation for nurses and physicians.