Early warning scores in the perioperative period: applications and clinical operating characteristics

We describe a framework to evaluate the balance between missed events and warning signals that are not followed by an adverse event (nonevents). In large surgical cohort studies, the missed event rates ranged between 19 and 69% and the nonevent rates ranged between 72 and 99% for ’optimal’ threshold early warning sores. Recent investigations have shown that there may be a substantial discrepancy between the theoretical benefits shown in validation studies and the practical clinical implementation of early warning scores, which may partly explain the absence of measurable benefit from these systems. Summary Early warning scores may facilitate protocolized escalation of care for patients at risk of adverse events and can be used in surgical and postoperative patients, but high nonevent rates and practical implementation problems can restrict their usefulness.
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Stephan A. Loer Source Type: research