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The 7-day mortality associated with an early warning score varies between age groups in a cohort of adult Danish emergency department patients

Dynesen, Jacob; Skov, Maj J.; Mackenhauer, Julie; Jessen, Marie K.; Liesanth, Janet Y.; Ebdrup, Lotte; Kirkegaard, Hans

European Journal of Emergency Medicine: December 2019 - Volume 26 - Issue 6 - p 453–457
doi: 10.1097/MEJ.0000000000000623
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Introduction: Early warning scores are designed for monitoring hospitalized patients and enable a timely response to deviating vital signs. The aim of this study was to examine whether 7-day mortality, associated with an initial early warning score, differs between age groups. Our hypothesis was that elderly patients are at greater risk of dying compared to a younger patient with a similar early warning score.

Methods: This observational cohort study included adult emergency department patients from five hospitals in Denmark over three consecutive months in 2015. Logistic regression was used to examine the relationship between patients’ initial early warning scores category (0, 1–2, 3–4, 5–6, 7+) and 7-day mortality in different age groups (16–59 years, 60–79 years, 80+ years). Mortality rates in each early warning scores category are compared between the youngest patients (16–59 years, reference group) and the two older age groups (60–79 years and 80+ years).

Results: A total of 19 123 emergency patients were included. The senior age groups (60–79 years and 80+ years) both displayed significantly higher 7-day mortality, in all early warning score categories, when compared to the youngest patients (16–59 years). The mortality difference between the youngest (16–59 years) and oldest age group (80+ years) remained significant in all early warning scores categories after adjusting for comorbidity.

Conclusion: Our findings show that the oldest emergency department patients (80+ years) have a higher 7-day mortality compared to young patients (16–59 years) with a similar initial early warning score.

Research Centre for Emergency Medicine, Aarhus University Hospital/Aarhus University, Aarhus N, Denmark

Received 25 March 2019 Accepted 19 June 2019

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.euro-emergencymed.com).

Correspondence to Jacob Dynesen, MD, Research Center for Emergency Medicine, Palle Juul-Jensens Boulevard 99, J103, 8200 Aarhus N, Denmark. Tel: +45 21 75 40 93; e-mail: jacobdynesen@gmail.com

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