Observational studyInternal and emergency medicine2019
Analysis of the early warning score to detect critical or high-risk patients in the prehospital setting.
Observational study in Internal and emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Review article: Use of prehospital early warning scores to predict short-term mortality: A systematic review.Emergency medicine Australasia : EMA · 2025Pooled it
- Pooled it
- Effectiveness of Early Warning Scores for Early Severity Assessment in Outpatient Emergency Care: A Systematic Review.Frontiers in public health · 2022Pooled it
- Prevalence of clinical deterioration in the pre-hospital setting.Emergency medicine Australasia : EMA · 2025Article
- Development and internal validation of an algorithm for estimating mortality in patients encountered by physician-staffed helicopter emergency medical services.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Modified Sequential Organ Failure Assessment Score vs. Early Warning Scores in Prehospital Care to Predict Major Adverse Cardiac Events in Acute Cardiovascular Disease.Journal of cardiovascular development and disease · 2023Article
- The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis.Annals of translational medicine · 2023Article
- Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments.Journal of personalized medicine · 2021Article
- A pre-hospital risk score predicts critical illness in non-trauma patients transported by ambulance to a Dutch tertiary referral hospital.Scandinavian journal of trauma, resuscitation and emergency medicine · 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
- Pre-hospital lowest recorded oxygen saturation independently predicts death in patients with COVID-19.British paramedic journal · 2020Article
- Role of qSOFA and SOFA Scoring Systems for Predicting In-Hospital Risk of Deterioration in the Emergency Department.International journal of environmental research and public health · 2020Article
- Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores.International journal of environmental research and public health · 2020Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
The early warning score can help to prevent, recognize and act at the first signs of clinical and physiological deterioration. The objective of this study is to evaluate different scales for use in the prehospital setting and to select the most relevant one by applicability and capacity to predict mortality in the first 48 h. A prospective longitudinal observational study was conducted in patients over 18 years of age who were treated by the advanced life support unit and transferred to the emergency department between April and July 2018. We analyzed demographic variables as well as the physiological parameters and clinical observations necessary to complement the EWS. Subsequently, each patient was followed up, considering their final diagnosis and mortality data. A total of 349 patients were included in our study. Early mortality before the first 48 h affected 27 patients (7.7%). The scale with the best capacity to predict early mortality was the National Early Warning Score 2, with an area under the curve of 0.896 (95% CI 0.82-0.97). The score with the lowest global classification error was 10 points with sensitivity of 81.5% (95% CI 62.7-92.1) and specificity of 88.5% (95% CI 84.5-91.6). The early warning score studied (except modified early warning score) shows no statistically significant differences between them; however, the National Early Warning Score 2 is the most used score internationally, validated at the prehospital scope and with a wide scientific literature that supports its use. The Prehospital Emergency Medical Services should include this scale among their operative elements to complement the structured and objective evaluation of the critical patient.
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Registered trials
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.