Key result
ViEWS moderately predicts ICU admission with an AUC of ~0.67 and speeds emergency care.
Why the study?
Early prediction of clinical deterioration in cardiac patients in the emergency department is a challenge, and the effectiveness of the VitalPAC Early Warning Score (ViEWS) in predicting ICU admission in this setting needed evaluation.
Does the VitalPAC Early Warning Score (ViEWS) paired with interactive COMPASS EWS workshops predict ICU admission and reduce time to emergency department interventions in cardiac emergency department patients?
Observational (n=636)
Yes
Does the VitalPAC Early Warning Score (ViEWS) paired with interactive COMPASS EWS workshops predict ICU admission and reduce time to emergency department interventions in cardiac emergency department patients?
Implementing ViEWS via interactive workshops in the emergency department showed moderate prognostic ability for ICU admission among cardiac patients while significantly reducing the time to initial clinical assessment and hospital admission.
Background Early prediction of cardiac patients’ deterioration in the emergency department (ED) is a challenge. Early warning scores (EWSs) gains attention as adjunct prognostic tools for clinical deterioration. Purpose To evaluate the effectiveness of the VitalPAC EWS (ViEWS) to predicting ICU admission in cardiac ED patients. Methods This multicenter, prospective observational study provided interactive "COMPASS" EWS workshops to two intervention settings. The other two EDs were the controls. Bedside observation primarily focused on ViEWS parameters time elapsed for ED interventions, and ICU admission. Results Of 636 cardiac ED admissions, 371 were patients in intervention settings, while 265 were patients in control settings. Intervention patients showed shorter times compared to controls regarding the interval between patient arrival and initial clinical assessment (5.43 vs. 7.31 minutes, respectively, p=0.001), and the interval between patient arrival and admission (if necessary) (72.70 vs. 98.23 minutes, respectively, p<0.001). The AUROC logistic model demonstrated 0.67 area under the curve (AUC) (Std. error: 0.022, P<0.001, and CI: 0.63−0.71) associated with the highest ViEWS threshold at a score of 5.5. Conclusions Despite its moderate prognostic ability for ICU admission, ViEWS contributed to expediting timely ED interventions.
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Kalaldeh et al. (2026) conducted an observational in Cardiac emergency department patients (n=636). VitalPAC Early Warning Score (ViEWS) with interactive COMPASS EWS workshops vs. Control emergency departments without COMPASS EWS workshops was evaluated on ICU admission prediction and time elapsed for ED interventions (arrival to initial clinical assessment and admission) (AUC 0.67, 95% CI 0.63-0.71, p=<0.001). ViEWS showed moderate ability to predict ICU admission (AUC 0.67; 95% CI 0.63-0.71; P<0.001) and reduced time to initial assessment (5.43 vs 7.31 min, p=0.001) and admission (72.70 vs 98.23 min).
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