General Condition
Conditions
Keywords
Early Warning Score (EWS), Deterioration of Patients' General Condition
Brief summary
An acute deterioration of a patients' general condition is often preceded by changes in individual vital parameters. An early warning system (EWS) shall be developed with a reduced number of physiological and individual parameters, compared to conventional early warning systems; and an algorithm will be generated that is able to predict clinical deterioration. Its predictive power and accuracy shall be investigated. In a second exploratory phase, different model variants will be analyzed and the applicability of the model variants in the context of continuous EWS on wearables will be examined.
Detailed description
An acute deterioration of a patients' general condition is often preceded by changes in individual vital parameters and may lead to adverse events, such as admission to the intensive care unit, heart attack or death. Some of them are potentially avoidable if appropriate measures are taken in a timely manner. Therefore early warning systems (Early Warning Scores= EWS) have been developed from a set of several physiological measurements, signs and symptoms. Individual parameters are weighted to sum up a score. Based on this score, the deterioration of a patients' general condition may be indicated and a predetermined reaction from the professional staff be triggered (so-called track-and-trigger system). It is important to determine all parameters since missing values influence the informative value of an EWS. This requires a higher effort by the staff and is one of the reasons why early warning systems are not yet used systematically in Switzerland. A reduction in the number of parameters to be measured could lower the hurdle for the use of these tools and enable a broader applicability. Therefore an early warning system shall be developed with a reduced number of physiological and individual parameters, compared to conventional early warning systems; and an algorithm will be generated that is able to predict clinical deterioration. Its predictive power and accuracy shall be investigated, based on various clinical outcomes such as mortality, cardiac arrest, transfer to the intensive care unit or sepsis. Retrospective, encrypted patient data (from 2016 until 2022) will be used to develop a statistical prediction model. In a second exploratory phase, different model variants will be analyzed and the applicability of the model variants in the context of continuous EWS on wearables will be examined.
Interventions
OTHERData collection for developing an algorithm for an Early Warning Score
Data collection of patient parameters (heart rate, respiratory rate, clinical outcomes (death, transfer to intensive care unit, adverse events like sepsis, infection, heart attack))
Sponsors
Innosuisse - Swiss Innovation Agency
University Hospital, Basel, Switzerland
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Hospitalized patients of surgical and medical wards of University Hospital Basel * Hospital stay longer than 24 hours * Signed general consent
Exclusion criteria
* Patients admitted directly to the intensive care unit * Rejection of general consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Accuracy of Early Warning Score | up to 72 hours after hospital admission | The accuracy of the early warning system in terms of its predictive power is measured by using the respective medical outcomes. Data models are used to create a relationship between the patient parameters (the predictors) and the clinical outcome (Condition stable vs. condition unstable: death, transfer to intensive care unit, heart attack, infection/sepsis, etc.) as a binary response variable (whether a deterioration occurs or not). |
Countries
Switzerland
Outcome results
None listed