Original ArticlesHow comorbidities impact Early Warning Score as a predictor of 7-day mortalityLangsted, Sandra Nima Damsholta; Dynesen, Jens Jacoba; Liesanth, Janet Ydea; Jessen, Marie Kristinea,,b; Mackenhauer, Juliea,,c; Ahrensberg, Jettea,,b; Kirkegaard, HansaAuthor Information aResearch Center for Emergency Medicine, Emergency Department and Department of Clinical Medicine, Aarhus University Hospital and Aarhus University bDepartment of Emergency medicine, Aarhus University hospital, Aarhus cDanish Center for Clinical Health Services Research (DACS), Department of Clinical Medicine, Aalborg University, Aalborg, Denmark Received 19 April 2019 Accepted 5 September 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 Sandra Nima Damsholt Langsted, MD, Bernhardt Jensens boulevard, 111, 2.1 8000 Aarhus C, Denmark, Tel: +45 20 27 65 12; e-mail: firstname.lastname@example.org European Journal of Emergency Medicine: April 2020 - Volume 27 - Issue 2 - p 142-146 doi: 10.1097/MEJ.0000000000000633 Buy SDC Metrics Abstract Background: Early Warning Score systems are used to monitor patients at risk of deterioration. How comorbidities impact Early Warning Score’s ability to predict short-term mortality in the emergency department is not fully elucidated. The aim of the study was to investigate how comorbidities impact Early Warning Score as predictor of 7-day mortality. Methods: This is an observational cohort study of adult emergency department patients attending one of the five emergency departments in Central Region Denmark from 1 March 2015 to 31 May 2015. Charlson Comorbidity Index was used as a measure of comorbidities. Logistic regression was used to calculate the odds ratio for 7-day mortality. Patients were compared in three groups: Charlson Comorbidity Index: 0, 1–2, 3+. Results: A total of 30 060 adult patients attended one of the five emergency departments. Nineteen thousand one hundred twenty-three patients were included. Charlson Comorbidity Index 3+ patients presenting with Early Warning Score 0, 1–2 or 3–4 had significantly higher odds ratio of 7-day mortality compared to Charlson Comorbidity Index 0 patients with equal Early Warning Score. For patients with Early Warning Score 5+, Charlson Comorbidity Index -status had no significant impact on 7-day mortality after adjusting for age. Conclusion: In patients presenting with lower acuity (Early Warning Score 0–4) Charlson Comorbidity Index has a significant impact on 7-day mortality regardless of Early Warning Score. Including Charlson Comorbidity Index status in Early Warning Score or adjusting for Charlson Comorbidity Index -status could increase the predictive value of Early Warning Score in predicting 7-day mortality. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.