A retrospective records review comparing the care of patients who either avoided or were admitted to an ICU following a ward-based deterioration event.
J Ede, H Pickworth, B Kent and 2 others
PMID 40513499WHAT IT FOUND
Patients who died after ward deterioration had higher care scores than survivors.
Most survivors avoided ICU by responding to ward treatment, but 33 of 340 still had an unresolved warning score at discharge.
Key findings
01Reviewers judged non-survivors to have higher median quality-of-care scores than survivors: 4 (IQR 1) versus 3 (IQR 1).
02Escalation according to local policy was recorded for 147/340 survivors (43.2%) and 36/50 non-survivors (72%).
03Most survivors avoided ICU by responding to ward-based treatments (250/340, 73.5%), but 33/340 (9.7%) still had an unresolved trigger at discharge.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective review of records, and care that was given but not documented may have been missed. The study only captured patients who triggered an Early Warning Score of 7 or more, not unwell patients who did not trigger. Some survivors may have improved because they had better physiological reserve, not because care rescued them. The authors note the data are from 2022 and advise caution. Only 50 non-survivors were reviewed.
Declared interests
The authors declare no known competing financial interests or personal relationships.
The easy way to misread this
Do not conclude that higher escalation or documentation caused survival. Patients who died had higher care scores than survivors, and they were older, had more comorbidities, higher trigger scores, and deteriorated earlier.