Investigating the Predictive Power of the National Early Warning Score in Predicting Outcomes Among Intensive Care Unit Patients Publisher



Yousefifard M ; Heydarzadeh Jazi M ; Esmaeili M ; Asgari P
Source: Critical Care Research and Practice Published:2026

Abstract

Aim: The aim of this study is to determine the predictive power of the National Early Warning Score in identifying the outcomes of intensive care unit (ICU) patients. Methods: In this study, 300 patients hospitalized in the ICUs (medical and general) of two teaching hospitals affiliated with Tehran University of Medical Sciences were evaluated and followed up for 30 days between June 2023 and April 2024. The samples were selected by convenience sampling based on inclusion criteria. A checklist containing the components of early warning criteria introduced by Braden, SOFA and APACHE II, as well as outcomes of hospitalization in the ward, was used. The early warning criteria were assessed by the researcher at the time of admission, as well as 6 and 24 h after the admission of patients to ICU. The collected data were analysed by SPSS-27 and STATA-14 software using Kruskal–Wallis, Pearson and chi-square tests, as well as the area under the receiver operating characteristic (ROC) curve of early warning system. Results: The mean age of patients was 41 years (31–56), and 63.70% of them were male. Comparison of the area under the ROC curve of early warning tool showed that the early warning score in predicting death at the time of admission, 6 h after admission and 24 h after admission was 0.697, 0.712 and 0.87, respectively. Also, this score in predicting adverse outcomes at the time of admission, 6 h after admission and 24 h after admission was 0.700, 0.784 and 0.936, respectively. In other words, the early warning system had a good predictive power in indicating the occurrence of outcomes at all three times (at admission, 6 hours after admission and 24 h after admission), but the best time to predict death and adverse outcomes was estimated to be 24 h after admission. Conclusion: By evaluating the predictive power of early warning score in identifying the outcomes of patients hospitalized in ICUs, we found that the early warning score at 24 h after admission had a higher predictive power than other times. Copyright © 2026 Mahmoud Yousefifard et al. Critical Care Research and Practice published by John Wiley & Sons Ltd.