The 7-day mortality associated with an early warning score varies between age groups in a cohort of adult Danish emergency department patients

Abstract

Introduction: Early warning scores are designed for monitoring hospitalized patients and enable a timely response to deviating vital signs. The aim of this study was to examine whether 7-day mortality, associated with an initial early warning score, differs between age groups. Our hypothesis was that elderly patients are at greater risk of dying compared to a younger patient with a similar early warning score. Methods: This observational cohort study included adult emergency department patients from five hospitals in Denmark over three consecutive months in 2015. Logistic regression was used to examine the relationship between patients’ initial early warning scores category (0, 1–2, 3–4, 5–6, 7+) and 7-day mortality in different age groups (16–59 years, 60–79 years, 80+ years). Mortality rates in each early warning scores category are compared between the youngest patients (16–59 years, reference group) and the two older age groups (60–79 years and 80+ years). Results: A total of 19 123 emergency patients were included. The senior age groups (60–79 years and 80+ years) both displayed significantly higher 7-day mortality, in all early warning score categories, when compared to the youngest patients (16–59 years). The mortality difference between the youngest (16–59 years) and oldest age group (80+ years) remained significant in all early warning scores categories after adjusting for comorbidity. Conclusion: Our findings show that the oldest emergency department patients (80+ years) have a higher 7-day mortality compared to young patients (16–59 years) with a similar initial early warning score.

A quick modified early warning score for triaging medical patients at admission

“…Scores lost part of their predicting capacity in elderly and women patients. Death in old patients could happen as a natural event, confirming the increased risk of elderly despite the same EWS values [13]; however, performances were similar to other reports [14,15]. Understanding differences in performance between sexes is more challenging, as frequencies of events and high score values are not different.…”

Including oxygen supplement in the early warning score: a prediction study comparing TOKS, modified TOKS and NEWS in a cohort of emergency patients

“…Ethics approval and consent to participate Data collection was approved by the Danish Patient Safety Authority (case no. : 3-3013-1186/1) [20]. Approval from an ethics committee was not required according to Danish law.…”

Comorbidity‐adjusted NEWS predicts mortality in suspected patients with COVID‐19 from nursing homes: Multicentre retrospective cohort study

“…Moreover, the role of comorbidities in the prognosis of patients with COVID‐19 has also been studied (Jain & Yuan, 2020 ; Price et al, 2020 ; Wang et al, 2020 ; Zhou et al, 2020 ). However, there are very few studies that correlate the use of early warning scores with the level of comorbidities (Covino et al, 2021 ; Dynesen et al, 2019 ; Langsted et al, 2020 ; Varol et al, 2021 ). In particular, (Kostakis et al, 2021 ) conclude that the addition of new covariates is unnecessary when evaluating patients with COVID‐19 using NEWS.…”

“…However, there are very few studies that correlate the use of early warning scores with the level of comorbidities (Covino et al, 2021;Dynesen et al, 2019;Langsted et al, 2020;Varol et al, 2021). In particular, (Kostakis et al, 2021) conclude that the addition of new covariates is unnecessary when evaluating patients with COVID-19 using NEWS.…”