Prytherch et al reported the ViEWS early warning score that was implemented on a PDA running the VitalPAC(TM) software. This can help to identify an inpatient who may be deteriorating. The authors are from the Portsmouth Hospitals NHS Trust, University of Bournemouth and University of Portsmouth in England.
Patient selection: inpatient
Parameters:
(1) pulse in beats per minute
(2) breathing rate in breaths per minute
(3) temperature in °C
(4) systolic blood pressure in mm Hg
(5) oxygen saturation in percent
(6) inspired oxygen
(7) CNS status using the AVPU scale
Parameter
Fiinding
Points
pulse
<= 40
2
41 to 50
1
51 to 90
0
91 to 110
1
111 to 130
2
>= 131
3
breathing rate
< 8
3
9 to 11
1
12 to 20
0
21 to 24
2
>= 25
3
temperature
<= 35.0°C
3
35.1 to 36.0
1
36.1 to 38.0
0
38.1 to 39.0
1
>= 39.1
2
systolic blood pressure
<= 90
3
91 to 100
2
101 to 110
1
111 to 249
0
>= 250
1
oxygen saturation
<= 91
3
92 to 93
2
94 to 95
1
>= 96
0
inspired oxygen
room air
0
any supplemental
3
CNS status
alert
0
VPU
3
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score the greater the risk of deterioration and mortality.
Score
24-Hour Mortality
0 to 3
0
4
0.7%
5 or 6
1.5%
7
3%
8
3.8%
9
6.2%
10
9.2%
11
13.8%
12
17.2%
13
21.5%
14
30.8%
15
36%
>=16
43.1%
Performance:
• The area under the ROC curve is 0.89.
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