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Centile-based early warning scores derived from statistical distributions of vital signs

Tarassenko, L and Clifton, DA and Pinsky, MR and Hravnak, MT and Woods, JR and Watkinson, PJ (2011) Centile-based early warning scores derived from statistical distributions of vital signs. Resuscitation, 82 (8). 1013 - 1018. ISSN 0300-9572

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Aim of study: To develop an early warning score (EWS) system based on the statistical properties of the vital signs in at-risk hospitalised patients. Materials and methods: A large dataset comprising 64,622 h of vital-sign data, acquired from 863 acutely ill in-hospital patients using bedside monitors, was used to investigate the statistical properties of the four main vital signs. Normalised histograms and cumulative distribution functions were plotted for each of the four variables. A centile-based alerting system was modelled using the aggregated database. Results: The means and standard deviations of our population's vital signs are very similar to those published in previous studies. When compared with EWS systems based on a future outcome, the cut-off values in our system are most different for respiratory rate and systolic blood pressure. With four-hourly observations in a 12-h shift, about 1 in 8 at-risk patients would trigger our alerting system during the shift. Conclusions: A centile-based EWS system will identify patients with abnormal vital signs regardless of their eventual outcome and might therefore be more likely to generate an alert when presented with patients with redeemable morbidity or avoidable mortality. We are about to start a stepped-wedge clinical trial gradually introducing an electronic version of our EWS system on the trauma wards in a teaching hospital. © 2011 Elsevier Ireland Ltd.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Tarassenko, L
Clifton, DA
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Hravnak, MTmhra@pitt.eduMHRA
Woods, JR
Watkinson, PJ
Date: 1 August 2011
Date Type: Publication
Journal or Publication Title: Resuscitation
Volume: 82
Number: 8
Page Range: 1013 - 1018
DOI or Unique Handle: 10.1016/j.resuscitation.2011.03.006
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0300-9572
PubMed ID: 21482011
Date Deposited: 07 Mar 2012 21:00
Last Modified: 24 Feb 2021 11:55


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