• Ola Friman, Max Bell, Therese Djärv, Andreas Hvarfner, and Gabriella Jäderling.
• Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
• Acta Anaesthesiol Scand. 2019 Feb 1; 63 (2): 215-221.

PurposeThe purpose of this study was to examine the prevalence of deviating vital parameters in general ward patients using rapid response team (RRT) criteria and National Early Warning Score (NEWS), assess exam duration, correct calculation and classification of risk score as well as mortality and adverse events.MethodsPoint prevalence study of vital parameters according to NEWS and RRT criteria of all adult patients admitted to general wards at a Scandinavian university hospital with a mature RRT.Primary Outcomeprevalence of at-risk patients fulfilling at least one RRT criteria, total NEWS of 7 or greater or a single NEWS parameter of 3 (red NEWS).Secondary Outcomesmortality in-hospital and within 30 days or adverse events within 24 hours.ResultsWe assessed 598 (75%) of 798 admitted patients and examiners captured a fulfilled RRT calling criterion in 50 patients (8.4%), 36 (6.0%) had NEWS ≥ 7, 34 with a red NEWS parameter. Red NEWS occurred in 112 patients (18.7%). Secondary outcomes were fulfilled in 49 patients (8.2%). Mortality overall was 6.5% within 30 days, 1.8% in hospital. In 134 patients (22.4%) the manual calculation of score for NEWS was incorrectly performed by examiner.ConclusionEven with a mature RRT in place, we captured patients with failing physiology in general wards reflecting afferent limb failure. Manual calculation of NEWS is frequently incorrect, possibly leading to misclassification of patients at risk.© 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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