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The effect of early warning scoring systems on adverse outcome in surgical patients: A systematic review

Annick Stolze1, Tara N M Woolley-Hendriks2, Yara Bassa1

  • 1Department of Anesthesiology, Amsterdam University Medical Centre, VU University, Amsterdam, The Netherlands.

International Journal of Nursing Studies Advances
|December 24, 2024
PubMed

Insights

Early warning scoring systems may reduce mortality and ICU admissions in surgical patients, but evidence is limited. More high-quality trials are needed to confirm the benefits of these systems for patient outcomes.

Area of Science:

  • Medical research
  • Clinical informatics
  • Patient safety

Background:

  • Early warning scoring systems aim to identify patient deterioration early.
  • Preventing failure-to-rescue is a key goal in hospitalized patients.
  • This review focuses on the impact of these systems in surgical populations.

Purpose of the Study:

  • To systematically review the effect of early warning scoring systems on adverse outcomes in surgical patients.
  • To assess the current evidence for the efficacy of these systems in improving patient safety.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Searched multiple databases (PubMed, Embase, CINAHL, Cochrane Library) up to June 2023.
  • Included randomized controlled trials and non-randomized studies evaluating early warning scoring systems with spot-check monitoring.

Main Results:

  • Eight studies were included, with two randomized controlled trials; overall risk of bias was high.
  • Three studies showed a significant decrease in mortality.
  • Decreases in cardiopulmonary arrests and ICU admissions were reported in some studies, but with heterogeneity.

Conclusions:

  • Current evidence supporting early warning scoring systems in surgical patients is low due to limited studies and design flaws.
  • Further well-designed trials are necessary to conclusively determine the impact on patient outcomes.
  • Improved study design is crucial for validating the effectiveness of these systems.
Abstract

Keywords:
Cardiopulmonary arrestClinical deteriorationEarly Warning ScoreFailure to rescueMortalityOutcome assessmentPatient acuitySurgical patientsSystematic review

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