Validation of an abbreviated Vitalpac™ Early Warning Score (ViEWS) in 75,419 consecutive admissions to a Canadian Regional Hospital

Background: The early warning score derived from 198,755 vital sign sets in the Vitalpac (TM) database (ViEWS) has an area under the receiver operator characteristic curve (AUROC) for death of acute unselected medical patients within 24 h of 88%. Methods: This study validated an abbreviated version of ViEWS, which did not include mental status, in 75,419 consecutive patients admitted to the Thunder Bay Regional Health Sciences Center between 2005 and 2010. Results: The abbreviated score had an AUROC for death within 48 h of admission of 93% for all patients and 89% for medical patients - there were no significant differences in the discrimination of the score between surgical and medical patients or patients admitted to different medical sub-specialty services. The AUROC for intensive care patients, however, was significantly lower at 72%. Although medical patients appeared to have a higher mortality than surgical patients with the same score, these only reached statistical significance for surgical patients with a score between 3 and 10 points, stroke patients between 3 and 6 points, oncology patients between 7 and 10 points, and ICU patients with 3 or more points. Conclusion: The abbreviated ViEWS score has comparable discrimination to the original score and has reasonable "goodness of fit" for most patients except for those requiring intensive care. (C) 2011 Elsevier Ireland Ltd. All rights reserved.