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Perioperative medicine (London, England). 2025 Apr 1;14(1):39. doi: 10.1186/s13741-025-00516-w Q32.02024

Performance of the early warning system score in predicting postoperative complications in older versus younger patients

早期预警系统评分在预测老年与年轻患者术后并发症中的表现 翻译改进

Annick Stolze  1, Lisette Vernooij  2  3, Dianne de Korte-de Boer  4, Markus W Hollmann  5, Wolfgang F F A Buhre  3, Christa Boer  6, Peter G Noordzij  2  3; TRACE Study Investigators Group

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作者单位

  • 1 Department of Anesthesiology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. a.stolze@amsterdamumc.nl.
  • 2 Department Anesthesiology, Intensive Care and Pain Management, St. Antonius Hospital Nieuwegein, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
  • 3 Department of Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
  • 4 Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
  • 5 Department of Anesthesiology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
  • 6 Department of Anesthesiology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
  • DOI: 10.1186/s13741-025-00516-w PMID: 40165340

    摘要 Ai翻译

    Background: Early warning system (EWS) scores are implemented on surgical wards to identify patients at high risk of postoperative clinical deterioration, but its predictive value in older patients is unclear. This study assessed the prognostic value of EWS scores to predict severe postoperative complications in older patients compared to younger patients.

    Methods: This study utilized data from the TRACE study. EWS scores were routinely measured on postoperative days one (POD1) and three (POD3). The cohort was divided by age: < 70 years and ≥ 70 years. Performance measures of EWS scores on POD1 and POD3 were assessed to predict severe postoperative complications. Missed event rates (proportion of events not detected by the EWS threshold) and nonevent rates (proportion of EWS values above the threshold without an adverse event) were calculated.

    Results: Among 4866 patients, 39.3% were ≥ 70 years old. Severe complications occurred in 6.1% of older compared to 5.8% of younger patients (P = 0.658). EWS scores on POD1 and POD3 did not differ between age groups. For severe complications, EWS showed moderate discrimination in both older (POD1: C-statistic 0.65 (95%CI 0.59-0.70); POD3: 0.63 (95%CI 0.57-0.69)) and younger patients (POD1: 0.68 (95%CI 0.65-0.72); POD3: 0.65 (95%CI 0.61-0.70)). Overall, calibration was good. For EWS score ≥ 3, the missed event rate was at least 69% and nonevent rate 75%.

    Conclusions: Predicted performance of the EWS score was moderate among older and younger patients. A limitation of the EWS score is the high rate of missed events and nonevents.

    Keywords: Calibration; Clinical deterioration; Discrimination; Early warning score; Frail elderly; Vital signs.

    Keywords:early warning system score; postoperative complications; older versus younger patients

    Copyright © Perioperative medicine (London, England). 中文内容为AI机器翻译,仅供参考!

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    期刊名:Perioperative medicine

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    ISSN:2047-0525

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    IF/分区:2.0/Q3

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    Performance of the early warning system score in predicting postoperative complications in older versus younger patients