ArticlePloS one2014
Prognosis and risk factors for deterioration in patients admitted to a medical emergency department.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03375658 (Cluster Randomized Trial of the Patient Deterioration Warning System in Emergency Departments), which is not on this map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Cluster Randomized Trial of the Patient Deterioration Warning System in Emergency Departments
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Machine learning techniques for mortality prediction in emergency departments: a systematic review.BMJ open · 2021Pooled it
- The value of vital sign trends in predicting and monitoring clinical deterioration: A systematic review.PloS one · 2019Pooled it
- Early warning scores and peripheral perfusion index: A Comparative assessment for 30-day mortality in critical patients in emergency departments.Irish journal of medical science · 2026Article
- Predicting ICU transfer for high-risk patients upon medical admission via the medical intensive care prediction score (MICAPS).BMC emergency medicine · 2026Article
- Giving patients, families and staff a reliable voice in acute care: Expert guidance for implementation of Martha's Rule in UK hospitals.Future healthcare journal · 2025Article
- Care Complexity Factors and Discharge Destination in an Emergency Department: A Retrospective Cohort Study.Archives of academic emergency medicine · 2025Article
- Modelling in-hospital length of stay: A comparison of linear and ensemble models for competing risk analysis.PloS one · 2025Article
- Provider perception of presentations with nonspecific back pain in the emergency department and primary care practices: a semi-structured interview study.International journal of emergency medicine · 2024Article
- Development of Prediction Model for Intensive Care Unit Admission Based on Heart Rate Variability: A Case-Control Matched Analysis.Diagnostics (Basel, Switzerland) · 2024Article
- Development and Validation of a Machine Learning Algorithm Using Clinical Pages to Predict Imminent Clinical Deterioration.Journal of general internal medicine · 2024Observational
- Process Evaluation of a Wireless Wearable Continuous Vital Signs Monitoring Intervention in 2 General Hospital Wards: Mixed Methods Study.JMIR nursing · 2023Article
- Piloting a Nurse-Led Critical Care Outreach Service to Pre-Empt Medical Emergency Team Calls and Facilitate Staff Learning.International journal of environmental research and public health · 2023Observational
- Reducing Crowding in Emergency Departments With Early Prediction of Hospital Admission of Adult Patients Using Biomarkers Collected at Triage: Retrospective Cohort Study.JMIR bioinformatics and biotechnology · 2022Article
- Using Facial Landmark Detection on Thermal Images as a Novel Prognostic Tool for Emergency Departments.Frontiers in artificial intelligence · 2022Article
- Preclinical evaluation of noncontact vital signs monitoring using real-time IR-UWB radar and factors affecting its accuracy.Scientific reports · 2021Article
- Frequency of alterations in qSOFA, SIRS, MEWS and NEWS scores during the emergency department stay in infectious patients: a prospective study.International journal of emergency medicine · 2021Article
- Vital Signs Prediction and Early Warning Score Calculation Based on Continuous Monitoring of Hospitalised Patients Using Wearable Technology.Sensors (Basel, Switzerland) · 2020Article
- Article
- Predicting cardiac arrest in the emergency department.Journal of the American College of Emergency Physicians open · 2020Review
- Repeated vital sign measurements in the emergency department predict patient deterioration within 72 hours: a prospective observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePatients that initially appear stable on arrival to the hospital often have less intensive monitoring of their vital signs, possibly leading to excess mortality. The aim was to describe risk factors for deterioration in vital signs and the related prognosis among patients with normal vital signs at arrival to a medical emergency department (MED). DESIGN AND
settingSingle-centre, retrospective cohort study of all patients admitted to the MED from September 2010-August 2011. SUBJECTS: Patients were included when their vital signs (systolic blood pressure, pulse rate, respiratory rate, Glasgow Coma Scale, oxygen saturation and temperature) were within the normal range at arrival. Deterioration was defined as a deviation from the defined normal range 2-24 hours after arrival.
results4292 of the 6257 (68.6%) admitted to the MED had a full set of vital signs at first presentation, 1440/4292 (33.6%) had all normal vital signs and were included in study, 44.0% were male, median age 64 years (5th/95th percentile: 21-90 years) and 446/1440 (31.0%) deteriorated within 24 hours. Independent risk factors for deterioration included age 65-84 years odds ratio (OR): 1.79 (95% confidence interval [CI]: 1.27-2.52), 85+ years OR 1.67 (95% CI: 1.10-2.55), Do-not-attempt-to-resuscitate order OR 3.76 (95% CI: 1.37-10.31) and admission from the open general ED OR 1.35 (95% CI: 1.07-1.71). Thirty-day mortality was 7.9% (95% CI: 5.5-10.7%) among deteriorating patients and 1.9% (95% CI: 1.2-3.0%) among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38-7.10).
conclusionsAmong acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open general ED. Thirty-day mortality among patients with deterioration was four times higher than among non-deteriorating patients. Further research is needed to determine whether intensified monitoring of vital signs can help to prevent deterioration or mortality among medical emergency patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.