Cochrane · systematic review · CD005529
Early warning systems and rapid response systems for the prevention of patient deterioration on acute adult hospital wards
McGaughey, J, Fergusson, DA, Van Bogaert, P, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Effective Practice and Organisation of CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
9
No studies
3
Included studies
NR
No studies 3 · 25%Ungraded 0 · 0%Very low 3 · 25%Low 5 · 41.7%Moderate 1 · 8.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Early warning systems (EWS) and rapid response systems (RRS) compared with usual care for prevention of patient deterioration on acute hospital wards
Population: adult on acute hospital wards at risk of clinical deterioration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hospital mortality – randomised trials ( Early warning systems (EWS) and rapid response systems (RRS) vs usual care | AOR 0.52 [0.32, 0.85] | 2792 participants | Low Downgraded: risk of bias, imprecision |
Hospital mortality – non‐randomised studies ( Early warning systems (EWS) and rapid response systems (RRS) vs usual care | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |
Composite outcome – randomised trials Composite outcome of incidence (events divided by number of eligible participants admitted to the hospital during the study period) of cardiac arrests without a pre‐existing NFR order, unplanned ICU admissions... Early warning systems (EWS) and rapid response systems (RRS) vs usual care | AOR 0.98 [0.83, 1.16] | 364094 participants | Moderate Downgraded: risk of bias |
Composite outcome – non‐randomised studies Composite endpoint of cardiopulmonary arrest, unplanned ICU admission or death per 1000 admitted patients ( Early warning systems (EWS) and rapid response systems (RRS) vs usual care | AOR 0.85 [0.72, 0.99] | 57858 participants | Low Downgraded: risk of bias |
Unplanned ICU admission – randomised trials ( Early warning systems (EWS) and rapid response systems (RRS) vs usual care | AOR 1.04 [0.89, 1.21] | 364094 participants | Low Downgraded: risk of bias, imprecision |
Unplanned ICU admission – non‐randomised trial ( Early warning systems (EWS) and rapid response systems (RRS) vs usual care | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |
ICU readmission – randomised trials Early warning systems (EWS) and rapid response systems (RRS) vs usual care | no estimate extracted | NR | No studies |
ICU readmission – non‐randomised studies Early warning systems (EWS) and rapid response systems (RRS) vs usual care | no estimate extracted | NR | No studies |
Length of hospital stay – randomised trials ( Early warning systems (EWS) and rapid response systems (RRS) vs usual care | HR 0.91 [0.83, 0.98] | 2733 participants | Low Downgraded: risk of bias, inconsistency |
Length of hospital stay – non‐randomised studies Early warning systems (EWS) and rapid response systems (RRS) vs usual care | no estimate extracted | NR | No studies |
Adverse events (unexpected cardiac or respiratory arrest) – randomised trials ( Early warning systems (EWS) and rapid response systems (RRS) vs usual care | AOR 0.94 [0.79, 1.13] | 364094 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (unexpected cardiac or respiratory arrest) – non‐randomised studies ( Early warning systems (EWS) and rapid response systems (RRS) vs usual care | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |