ArticleTherapeutics and clinical risk management2018
The impact of introducing the early warning scoring system and protocol on clinical outcomes in tertiary referral university hospital.
Article in Therapeutics and clinical risk management, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Does the use of National Early Warning Scores (NEWS or NEWS2) in healthcare settings improve patient outcomes: a systematic review.Systematic reviews · 2026Pooled it
- Early warning systems and rapid response systems for the prevention of patient deterioration on acute adult hospital wards.The Cochrane database of systematic reviews · 2021Pooled it
- Comparison of high-flow nasal oxygen therapy and noninvasive ventilation in suspected sepsis patients with acute respiratory distress in the emergency department: a retrospective cohort study.International journal of emergency medicine · 2025Article
- Effect of the Ramathibodi Rapid Response System Triggered by the Ramathibodi Early Warning Score and Clinical Warning Signs on in-Hospital Mortality and the Incidence of Cardiopulmonary Resuscitation in Adult Hospitalized Patients.Therapeutics and clinical risk management · 2023Article
- Evaluation of respiratory rate monitoring using a microwave Doppler sensor mounted on the ceiling of an intensive care unit: a prospective observational study.Journal of clinical monitoring and computing · 2022Observational
- The Use of qSOFA, SOFA, and Ramathibodi Early Warning Score (REWS) to Predict Severe Complications in Hematologic Malignancy Patients.Open access emergency medicine : OAEM · 2022Article
- Implementation of an Electronic National Early Warning System to Decrease Clinical Deterioration in Hospitalized Patients at a Tertiary Medical Center.International journal of environmental research and public health · 2021Article
- Survey of Nursing Staff's Training on Early Warning Ability for Inpatients with "Three Infarcts and One Hemorrhage".Evidence-based complementary and alternative medicine : eCAM · 2021Article
- Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to evaluate the impact of a hospital protocol in response to patient deterioration in general wards, stratified using the national early warning score (NEWS), on primary patient outcomes of in-hospital mortality and percentage of patients transferred to the intensive care unit (ICU). PATIENTS AND
methodsWe conducted a prospective observational cohort study among adult medical patients admitted to a university hospital in Bangkok. A 4-month pre-protocol period (November 2015 to February 2016) was assigned to a control group and a protocol period (March 2016 to June 2016) was allocated to a protocol group. On admission, vital signs (respiratory rate, pulse rate, systolic blood pressure, and temperature), oxygen saturation, presence of oxygen supplementation, and neurological status were used to calculate NEWS. Patients were categorized as low, moderate, or high risk based on the NEWS. During protocol period, when patients' conditions are critical and they are at imminent risk, the NEWS detects the event and triggers a systematic response. The response enables closed monitoring and early treatment by expert physicians to rapidly stabilize and triage the patient to a location where services meet the patient's needs. Primary outcomes were compared between the pre-protocol and protocol groups using historical controls for the intervention, which is the availability of NEWS to staff and an associated escalation pathway.
resultsA total of 1,145 patients were included in the analysis: 564 patients in the pre-protocol group and 581 in the protocol group. The mean NEWS of patients at admission was higher in the protocol group than in the pre-protocol group (2.4±2.4 vs 1.77±2.158;
conclusionImplementing the NEWS with the hospital protocol did not change the overall patient's outcomes.
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