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Evidence summaries

Early Warning Systems (Ews) and Rapid Response Systems (Rrs) for the Prevention of Intensive Care Admission and Death of Adult Patients on General Hospital Wards

There is insufficient evidence regarding the effect early warning systems (EWS) or rapid response systems (RRS) have in hospital mortality, unplanned ICU admissions, length of hospital stay or adverse events. Level of evidence: "D"

Comment: The quality of evidence is downgraded by study limitations (lack of blinding), and by imprecise results.

A Cochrane review [Abstract] 1 included 4 RCTs with 455,226 participants. All studies implemented an intervention comprising an early warning system (EWS) and rapid response system (RRS) conducted in high- or middle-income countries. Meta-analyses were not possible due to clinical and methodological heterogeneity across studies. EWS and RRS may lead to little or no difference in hospital mortality, unplanned ICU admissions, length of hospital stay or adverse events. In regards of a composite outcome of unexpected cardiac arrests, unplanned ICU admissions and death, 1 RCT showed that EWS and RRS intervention probably results in no difference (aOR 0.98, 95% CI 0.83 to 1.16; n=364,094).

    References

    • McGaughey J, Fergusson DA, Van Bogaert P et al. Early warning systems and rapid response systems for the prevention of patient deterioration on acute adult hospital wards. Cochrane Database Syst Rev 2021;(11):CD005529. [PubMed]

Primary/Secondary Keywords