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Is the New Zealand Early Warning Score useful following cardiac surgery?

Abstract The rate of medical emergency team (MET) calling among post-cardiac surgery patients is unknown. We set out to determine what the call frequency would be if MET activation occurred in every instance that the early warning score (EWS) breached our local threshold, what the outcome was for these patients and what the calling rate might be if the proposed New Zealand EWS (NZEWS) system was implemented with 100% adherence.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the new zealand medical journal
Publication Year Start




PMID- 28859061
OWN - NLM
STAT- In-Process
DA  - 20170831
LR  - 20170831
IS  - 1175-8716 (Electronic)
IS  - 0028-8446 (Linking)
VI  - 130
IP  - 1461
DP  - 2017 Sep 01
TI  - Is the New Zealand Early Warning Score useful following cardiac surgery?
PG  - 9-14
AB  - AIMS: The rate of medical emergency team (MET) calling among post-cardiac surgery
      patients is unknown. We set out to determine what the call frequency would be if 
      MET activation occurred in every instance that the early warning score (EWS)
      breached our local threshold, what the outcome was for these patients and what
      the calling rate might be if the proposed New Zealand EWS (NZEWS) system was
      implemented with 100% adherence. METHODS: The clinical records of 400 consecutive
      post-cardiac surgery patients were examined. The number of times a patient's EWS 
      reached the threshold which mandated a call to the MET was determined, as was the
      actual rate of calling, the occurrence of inpatient death and re-admission to the
      intensive care unit (ICU). The rate of calling was then determined using the
      NZEWS, and with a routine modification to the heart rate score. RESULTS: There
      were 73 occasions (MET events) where the EWS reached the MET calling threshold.
      The MET was only called twice. There were no inpatient deaths and 12 ICU
      re-admissions in the study cohort. Nine ICU re-admissions were preceded by a MET 
      event, two by cardiac arrest and one had neither. Re-scoring with NZEWS yielded
      53 events. Eight of the 12 ICU admissions were preceded by a NZEWS event.
      CONCLUSIONS: The rate of MET triggering EWS in patients post-cardiac surgery is
      high at 182/1,000 admissions. Using NZEWS could reduce the MET calling rate
      without significant risk to patient safety.
FAU - Peek, Kevin Niall
AU  - Peek KN
AD  - Auckland District Health Board, Auckland.
FAU - Gillham, Michael
AU  - Gillham M
AD  - Cardiothoracic and Vascular Intensive Care and High Dependency Unit. Auckland
      District Health Board, Auckland.
LA  - eng
PT  - Journal Article
DEP - 20170901
PL  - New Zealand
TA  - N Z Med J
JT  - The New Zealand medical journal
JID - 0401067
COI - Nil.
EDAT- 2017/09/01 06:00
MHDA- 2017/09/01 06:00
CRDT- 2017/09/01 06:00
PST - epublish
SO  - N Z Med J. 2017 Sep 1;130(1461):9-14.