OWN - NLM
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.