Evidence map›Paper›PMID 40165340›Full record

ArticlePerioperative medicine (London, England)2025

Performance of the early warning system score in predicting postoperative complications in older versus younger patients.

Annick Stolze, Lisette Vernooij, Dianne de Korte-de Boer, Markus W Hollmann, Wolfgang F F A Buhre, Christa Boer, Peter G Noordzij, TRACE Study Investigators Group

Abstract read
In one paragraph

Article in Perioperative medicine (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Annick StolzeDepartment of Anesthesiology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. a.stolze@amsterdamumc.nl.ORCID http://orcid.org/0000-0002-5097-1644
Lisette VernooijDepartment Anesthesiology, Intensive Care and Pain Management, St. Antonius Hospital Nieuwegein, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
Dianne de Korte-de BoerDepartment of Anesthesiology and Pain Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
Markus W HollmannDepartment of Anesthesiology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Wolfgang F F A BuhreDepartment of Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Christa BoerDepartment of Anesthesiology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Peter G NoordzijDepartment Anesthesiology, Intensive Care and Pain Management, St. Antonius Hospital Nieuwegein, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
TRACE Study Investigators Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly warning system (EWS) scores are implemented on surgical wards to identify patients at high risk of postoperative clinical deterioration, but its predictive value in older patients is unclear. This study assessed the prognostic value of EWS scores to predict severe postoperative complications in older patients compared to younger patients.

methodsThis study utilized data from the TRACE study. EWS scores were routinely measured on postoperative days one (POD1) and three (POD3). The cohort was divided by age: < 70 years and ≥ 70 years. Performance measures of EWS scores on POD1 and POD3 were assessed to predict severe postoperative complications. Missed event rates (proportion of events not detected by the EWS threshold) and nonevent rates (proportion of EWS values above the threshold without an adverse event) were calculated.

resultsAmong 4866 patients, 39.3% were ≥ 70 years old. Severe complications occurred in 6.1% of older compared to 5.8% of younger patients (P = 0.658). EWS scores on POD1 and POD3 did not differ between age groups. For severe complications, EWS showed moderate discrimination in both older (POD1: C-statistic 0.65 (95%CI 0.59-0.70); POD3: 0.63 (95%CI 0.57-0.69)) and younger patients (POD1: 0.68 (95%CI 0.65-0.72); POD3: 0.65 (95%CI 0.61-0.70)). Overall, calibration was good. For EWS score ≥ 3, the missed event rate was at least 69% and nonevent rate 75%.

conclusionsPredicted performance of the EWS score was moderate among older and younger patients. A limitation of the EWS score is the high rate of missed events and nonevents.

Indexed as

CalibrationClinical deteriorationDiscriminationEarly warning scoreFrail elderlyVital signs

Identifiers

PMID40165340
PMCPMC11959713

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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.