Early warning score predicts acute mortality in stroke patients

J. Liljehult, T. Christensen

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Objectives –Clinical deterioration and death among patients withacute stroke are often preceded by detrimental changes inphysiological parameters. Systematic and effective tools to identifypatients at risk of deterioration early enough to intervene aretherefore needed. The aim of the study was to investigate whether theaggregate weighted track and trigger system early warning score(EWS) can be used as a simple observational tool to identify patientsat risk and predict mortality in a population of patients with acutestroke.Materials and methods –Patients admitted with acute stroke atthe Copenhagen University Hospital, Nordsjællands Hospital,Denmark, from May to September 2012 were enrolled in aretrospective cohort study (n=274). Vital signs were measuredimmediately after admission and consistently during thehospitalization period. Based on the vital signs, a single compositeEWS was calculated. Death within 30 days was used as outcome.Area under the receiver operating characteristics curve (AUROC) anda Kaplan–Meier curve were computed to examine the prognosticvalidity of EWS.Results –A total of 24 patients (8.8%) died within30 days. The prognostic performance was high for both the EWS atadmission (AUROC 0.856; 95% CI 0.760–0.951; P-value<0.001) andthe maximal EWS measured (AUROC 0.949; 95% CI 0.919–0.980;P-value<0.001). Mortality rates were lowest for admission EWS 0–1(2%) and highest for admission EWS≥5 (63%).Conclusions –Earlywarning score is a simple and valid tool for identifying patients at riskof dying after acute stroke. Readily available physiological parametersare converted to a single score, which can guide both nurses andphysicians in clinical decision making and resource allocation.
TidsskriftActa Neurologica Scandinavica
Udgave nummer4
Sider (fra-til)261-267
Antal sider7
StatusUdgivet - 1 apr. 2016
Udgivet eksterntJa


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