SynthesisPloS one2022
The use of early warning system scores in prehospital and emergency department settings to predict clinical deterioration: A systematic review and meta-analysis.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07577349 (Performance of Different Early Warning Systems in Predicting 28-day Mortality Among Geriatric Emergency Department Patients), which is not on this map. Cited by 53 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.
Performance of Different Early Warning Systems in Predicting 28-day Mortality Among Geriatric Emergency Department Patients
Who cites it
53 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Review article: Use of prehospital early warning scores to predict short-term mortality: A systematic review.Emergency medicine Australasia : EMA · 2025Pooled it
- Systematic evaluation of predictive models for futile recanalization before thrombectomy in patients with acute ischemic stroke.Frontiers in neurology · 2025Pooled it
- Machine learning for risk stratification in the emergency department (MARS-ED): a randomized controlled trial.Nature communications · 2025Trial
- Assessing Risk of Early ICU Admission or Death at Emergency Department Triage: Clinical Judgment Versus Early Warning Scores.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Observational
- Combined application of the modified early warning score and the modified hematoma expansion prediction score for predicting hematoma expansion in intracerebral hemorrhage.Scientific reports · 2026Article
- A Simple Admission-Based Score for Early Mortality Risk Stratification in Non-Shock Sepsis: A Pilot Study.Diagnostics (Basel, Switzerland) · 2026Article
- Early detection of glycocalyx and microvascular damage in suspected sepsis in the emergency department: the EDGE study.Critical care (London, England) · 2026Observational
- Early Warning Scores in Emergency Department Patients Aged 80 Years or Older.JAMA network open · 2026Article
- Comparative prognostic performance of identification of seniors at risk tool and national early warning score for 30-day adverse outcomes in older emergency department patients.BMC emergency medicine · 2026Observational
- Combining the National Early Warning Score 2 with Frailty Assessment to Identify Patients at Risk of In-Hospital Cardiac Arrest: A Descriptive Exploratory Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Non-contact (touchless) monitoring of respiratory rate in a challenging anesthesia setting using a depth camera.Journal of clinical monitoring and computing · 2026Article
- Evaluating the real-world utility of four physiological scores for prehospital interventions in resource-limited EMS systems: a population-based study of 15,720 cases.BMC health services research · 2026Article
- Predictive Value of SpO2/RR Ratio for Short-Term Intubation and Mortality Risks in Pre-ED Patients With Acute Dyspnea Without Oxygen Therapy: A Retrospective Cohort Study.Emergency medicine international · 2026Article
- Predictive Value of Combined MEWS and NIPDS Scores for 24-Hour Clinical Deterioration in Emergency Observation Patients: A Prospective Cohort Study.Journal of multidisciplinary healthcare · 2026Article
- Clinical Gestalt to Predict Bacterial Infection and Mortality in Emergency Department Patients: A Prospective Observational Study.Journal of general internal medicine · 2026Observational
- Machine learning-based mortality prediction models for emergency department patients: a comparative analysis.Frontiers in medicine · 2026Article
- Delta MEWS combined with SpOFrontiers in medicine · 2026Article
- Predictive model for managing the clinical risk of emergency department patients: protocol for a systematic review.BMJ health & care informatics · 2025Article
- A nomogram and risk stratification for predicting subsyndromal delirium in elderly patients in a post-anaesthesia care unit: A prospective cohort study.International journal of nursing studies advances · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unclear which Early Warning System (EWS) score best predicts in-hospital deterioration of patients when applied in the Emergency Department (ED) or prehospital setting.
methodsThis systematic review (SR) and meta-analysis assessed the predictive abilities of five commonly used EWS scores (National Early Warning Score (NEWS) and its updated version NEWS2, Modified Early Warning Score (MEWS), Rapid Acute Physiological Score (RAPS), and Cardiac Arrest Risk Triage (CART)). Outcomes of interest included admission to intensive care unit (ICU), and 3-to-30-day mortality following hospital admission. Using DerSimonian and Laird random-effects models, pooled estimates were calculated according to the EWS score cut-off points, outcomes, and study setting. Risk of bias was evaluated using the Newcastle-Ottawa scale. Meta-regressions investigated between-study heterogeneity. Funnel plots tested for publication bias. The SR is registered in PROSPERO (CRD42020191254).
resultsOverall, 11,565 articles were identified, of which 20 were included. In the ED setting, MEWS, and NEWS at cut-off points of 3, 4, or 6 had similar pooled diagnostic odds ratios (DOR) to predict 30-day mortality, ranging from 4.05 (95% Confidence Interval (CI) 2.35-6.99) to 6.48 (95% CI 1.83-22.89), p = 0.757. MEWS at a cut-off point ≥3 had a similar DOR when predicting ICU admission (5.54 (95% CI 2.02-15.21)). MEWS ≥5 and NEWS ≥7 had DORs of 3.05 (95% CI 2.00-4.65) and 4.74 (95% CI 4.08-5.50), respectively, when predicting 30-day mortality in patients presenting with sepsis in the ED. In the prehospital setting, the EWS scores significantly predicted 3-day mortality but failed to predict 30-day mortality.
conclusionEWS scores' predictability of clinical deterioration is improved when the score is applied to patients treated in the hospital setting. However, the high thresholds used and the failure of the scores to predict 30-day mortality make them less suited for use in the prehospital setting.
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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.