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Review
. 2024 Oct 28:7:100256.
doi: 10.1016/j.ijnsa.2024.100256. eCollection 2024 Dec.

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

Annick Stolze  1 , Tara N M Woolley-Hendriks  2 , Yara Bassa  1 , Ralph de Vries  3 , Christa Boer  1 , Peter G Noordzij  2
Affiliations
Review

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

Annick Stolze et al. Int J Nurs Stud Adv. .

Abstract

Background: An early warning scoring system aims to detect clinical deterioration at an early stage and prevent failure-to-rescue in hospitalized patients. In this systematic review we studied the effect of an early warning scoring system on adverse outcome in surgical patients.

Methods: This review was conducted and reported according to PRISMA and the protocol of this review is registered at PROSPERO, under the registration number CRD42018107799. PubMed, Embase.com, CINAHL (Ebsco) and Wiley/Cochrane Library were searched from inception up to 20-06-2023 for randomized controlled trials and non-randomized studies of interventions. Studies were eligible for inclusion if the effect of an early warning scoring system using spot check monitoring was studied.

Results: Eight articles were included, of which two were randomised controlled trials. The overall risk of bias was high. A statistically significant decrease in mortality was seen in three studies. Two studies reported a decrease in cardiopulmonary arrests, and three studies found a decrease in ICU-admissions. There was heterogeneity among studies regarding the types of complications that were reported.

Conclusions: The evidence in favor of an early warning scoring system to reduce complications and mortality in surgical patients is low, mainly due to a limited number of studies and poor study design. Well-designed trials are needed to investigate whether an early warning scoring system improves outcome in surgical patients.

Keywords: Cardiopulmonary arrest; Clinical deterioration; Early Warning Score; Failure to rescue; Mortality; Outcome assessment; Patient acuity; Surgical patients; Systematic review.

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Conflict of interest statement

None.

Figures

Fig 1
Fig. 1
PRISMA flow diagram.
See this image and copyright information in PMC

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