Evidence map›Paper›PMID 41047463›Full record

Observational studyEuropean geriatric medicine2026

Validation and performance of a geriatric early warning score (GEWS) versus the national early warning score (NEWS) in predicting clinical deterioration in frail older patients.

H Baeyens, F Haegdorens, S Martens, M E Vanden Abeele, S Wallaert, N Van Den Noortgate, A D H Brys

Registry-linked trialAbstract readObservational StudyMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European geriatric medicine, 2026. 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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT07577349 completednot on this map

Performance of Different Early Warning Systems in Predicting 28-day Mortality Among Geriatric Emergency Department Patients

TypeobservationalSponsorHaseki Training and Research HospitalRan2025 to 2026Enrolled2,744ConditionsMortality, Clinical Deterioration, Geriatric Patients, FrailtyArmsDemographic Characteristics, Comorbidities, Vital Signs, Laboratory Parameters, Severity Scores
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

H BaeyensDepartment of Geriatrics, Faculty of Medicine and Health Science, Academic Consultant Ghent University and KU Leuven, Staff Member Health Policy at Solidaris Health Insurance, Brussels, Belgium. Hilde.Baeyens@skynet.be.ORCID http://orcid.org/0009-0009-9236-6117
F HaegdorensNurse and Midwifery Sciences, Centre for Research and Innovation in Care (CRIC), Workforce Management and Outcome Research in Care Group, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.ORCID http://orcid.org/0000-0003-1996-8786
S MartensDepartment of Geriatrics, St Trudo Hospital, Sint-Truiden, Belgium.
M E Vanden AbeeleDepartment of Geriatrics, Jessa Hospital, Hasselt, Belgium.ORCID http://orcid.org/0000-0003-0509-7414
S WallaertBiostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
N Van Den NoortgateDepartment of Geriatrics, Ghent University Hospital, 9000, Ghent, Belgium.ORCID http://orcid.org/0000-0001-5546-5380
A D H BrysDepartment of Geriatrics, Ghent University Hospital, 9000, Ghent, Belgium.ORCID http://orcid.org/0000-0003-2900-5609

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA Geriatric Early Warning Score (GEWS) for detecting clinical deterioration in frail older individuals was developed to account for age-related altered physiological responses and was based on the framework of the National Early Warning Score (NEWS), expert consensus and existing literature. This study aimed to validate GEWS and compare its predictive accuracy with the NEWS, as well as to evaluate the clinical burden of predefined thresholds.

methodsIn this prospective multicenter observational study, patients receiving acute geriatric care were included. Clinical deterioration was defined as: (1) unexpected death, (2) Intensive Care Unit transfer, (3) transition to palliative care, or (4) urgent medical/surgical intervention.

resultsAmong 511 patients, 348 events occurred in 297 individuals. We found higher AUROC 0.796 [95% CI 0.770-0.822] and PR-AUC values 0.412 [95% CI 0.350-0.472] for GEWS compared to NEWS 0.732 [95% CI 0.697-0.765] and 0.305 [95% CI 0.249-0.365] respectively (p < 0.0001). The GEWS ≥ 5 compared to NEWS ≥ 5 was superior in accuracy (0.940 vs. 0.927), PPV (0.497 vs. 0.365), and specificity (0.977 vs. 0.967), (all p < 0.0001). Moreover, a lower-number-needed-to-evaluate (NNE) (2.013 vs. 2.738, p < 0.0001) and a higher alerted-outcome-event-rate (AOER 4.424 vs. 3.706, p < 0.0005) resulted in lower clinical burden. For life-threatening events (Type 1-3), GEWS ≥ 8 compared to NEWS ≥ 7 showed higher specificity (0.999 vs. 0.995, p < 0.0001) and reduced rate-of-alerts (ROA 0.518 vs.1.347, p < 0.0001).

conclusionGEWS more accurately detects clinical deterioration within 12 h in frail older adults than NEWS, with less clinical burden. GEWS ≥ 5 is recommended for clinical alerting, whereas ≥ 8 for more urgent medical assistance.

Indexed as

Clinical DeteriorationEarly Warning ScoreFrail ElderlyGeriatric AssessmentAgedAged, 80 and overFemaleHumansIntensive Care UnitsMalePredictive Value of TestsProspective StudiesClinical burdenEWSFrailGEWSOlder peopleValidation

Identifiers

PMID41047463
PMCPMC13109162

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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.