Table 4.
Summary of early warning system effectiveness study outcomes
| Outcome | First author, year | Intervention | PTTT | Country | Number of centres | Specialist unit? | Existing RRT/ MET? |
Population | Study design | Study duration in months | Events before, n (rate) | Events after, n (rate) |
Effect size (95% CI) | P value | Quality score (max=26) | |||
| Implemented a new PTTT | Implemented new RRT/ MET |
Modified escalation process | Staff training/ education |
|||||||||||||||
| Mortality | ||||||||||||||||||
| Deaths on ward (per 1000 admissions) | Tibballs 200513 | ✓ | ✓ | ✓ | Melbourne Activation Criteria | Australia | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 53 (41 before, 12 after) |
13 (0.12) |
2 (0.06) |
RR=0.45 (0.10 to 1.99)† |
0.29 | 10 | |
| Hospital-wide deaths (per 100 discharges) | Sharek 200717 | ✓ | ✓ | ✓ | Paediatric rapid response team (RRT) triggering criteria | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 84 (67 before, 17 after) |
547 (1.01) |
158 (0.83) |
RR=0.82 (0.70 to 0.95) |
0.007 | 15 | |
| Hospital-wide deaths, excluding neonate ICU and ED (per 1000 discharges) | Zenker 200760 | ✓ | ✓ | RRT activation criteria* | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 34 (23 before, 11 after) |
97 (4.30) |
52 (4.45) |
RR=1.04 (0.74 to 1.45)† |
0.57 | 12 | ||
| Deaths outside ICU (per 1000 non-ICU patient-days) | Brilli 200715 | ✓ | ✓ | ✓ | Paediatric medical emergency team triggering criteria (a) | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 27 (15 before, 12 after) |
9 (0.10) |
2 (0.04) |
RR=0.39 (0.08 to 1.80)† |
0.13 | 14 | |
| Ward death rate (per 1000 ward admissions) | Hanson 201061 | ✓ | ✓ | ✓ | Not described | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (retrospective) | 36 (24 before, 12 after) |
13 (1.50) |
2 (0.45) |
RR=0.30 (0.07 to 1.31)† |
0.07 | 18 | |
| Total hospital deaths (per 1000 admissions) | Tibballs 200962 | ✓ | ✓ | ✓ | Melbourne Activation Criteria | Australia | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 89 (41 before, 48 after) |
459 (4.38) |
398 (2.87) |
RR=0.65 (0.57 to 0.75) |
<0.0001 | 15 | |
| Deaths on ward (per 1000 admissions) | Tibballs 200962 | ✓ | ✓ | ✓ | Melbourne Activation Criteria | Australia | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 89 (41 before, 48 after) |
13 (0.12) |
6 (0.04) |
RR=0.35 (0.13 to 0.92) |
0.03 | 15 | |
| All-cause hospital mortality (per 1000 admissions) | Kotsakis 201163 | ✓ | ✓ | Modified Melbourne Activation Criteria | Canada | 4 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
553 (9.97) |
540 (9.65) |
RR=0.97 (0.83 to 1.12) | 0.65 | 18 | ||
| All-cause hospital mortality (per 1000 discharges) | Parshuram 201864 | ✓ | ✓ | ✓ | Bedside PEWS | Belgium, Ireland, The Netherlands, England, Italy, Canada, New Zealand | 21 | Y | N | All inpatients | Cluster randomised trial (prospective) | 18 (6 pre, 12 post) |
Con: 61 (1.31) |
Con: 147 (1.56) |
OR=1.01 (0.61 to 1.69) |
0.96 | 23 | |
| Int: 52 (1.95) |
Int: 97 (1.93) |
|||||||||||||||||
| Hospital mortality (per 1000 admissions) | Kutty 201873 | ✓ | NR | USA | 38 | Y | N | All inpatients | Interrupted time series (retrospective) | 180 (60 before, 120 after) |
N/A | N/A | OR=0.94 (0.93 to 0.95) |
0.98 | 20 | |||
| PICU mortality | ||||||||||||||||||
| PICU mortality after PICU admission from ward (per PICU admission) | Anwar-al-Haque, 201018 | ✓ | ✓ | Paediatric RRT triggering criteria (b) | Pakistan | 1 | Y | N | All inpatients | Uncontrolled before-after study (retrospective) | 18 (9 before, 9 after) |
23 (51.11) |
5 (15.63) |
RR=0.31 (0.13 to 0.72)† |
0.007† | 6 | ||
| PICU mortality after PICU readmission within 48 hours of discharge (per 1000 admissions) | Kotsakis 201163 | ✓ | ✓ | Modified Melbourne Activation Criteria | Canada | 4 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
16 (0.29) |
7 (0.13) |
RR=0.43 (0.17 to 0.99) |
<0.05 | 18 | ||
| PICU mortality after urgent PICU admission from ward (per 1000 admissions) | Kotsakis 201163 | ✓ | ✓ | Modified Melbourne Activation Criteria | Canada | 4 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
70 (1.3) |
61 (1.1) |
RR=0.90 (0.70 to 1.00) |
0.25 | 18 | ||
| Death prior to discharge (per unplanned PICU transfer) | Bonafide 201465 | ✓ | ✓ | Bedside PEWS | USA | 1 | Y | N | All inpatients | Interrupted time series study (prospective) | 59 (32 before, 27 after) |
51 (6.3) |
56 (6.5) |
RR=1.03 (0.72 to 1.49)† |
0.99 | 23 | ||
| PICU mortality (per PICU admission) | Duns 201466 | ✓ | Between the Flags (BTS) tool* | Australia | 1 | Y | Y | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
30 (8.57) |
20 (5.49) |
RR=0.64 (0.37 to 1.11)† |
0.14 | 7 | |||
| Death in PICU (per 1000 patient-days) | Agulnik 201767 | ✓ | ✓ | Children’s Hospital Cardiac Early Warning Score (C-CHEWS) | Guatemala | 1 | Y | N | Oncology unit | Uncontrolled before-after study (retrospective) | 24 (12 before, 12 after) |
21 (1.25) |
22 (1.10) |
RR=0.89 (0.49 to 1.61)† |
0.76 | 19 | ||
| Death in PICU (per emergency PICU admission) | Sefton 201568 | ✓ | ✓ | ✓ | Modified Bristol PEWT (a) | UK | 1 | Y | N | All PICU admissions | Controlled before-after study (retrospective) | 24 (12 before, 12 after) |
17 (10.8) |
14 (8.4) |
RR=0.78 (0.40 to 1.53)† |
0.47 | 16 | |
| Deaths in PICU (per unplanned PICU admission) | Kolovos 201869 | ✓ | ✓ | RRT activation criteria* | USA | 1 | Y | N | All unplanned PICU admissions | Uncontrolled before-after study (retrospective) | 78 (42 before, 36 after) |
54† (4.9) |
40† (3.8) |
RR=0.77 (0.52 to 1.15)† |
0.20† | 12 | ||
| PICU mortality (per 1000 discharges) | Parshuram 201864 | ✓ | ✓ | ✓ | Bedside PEWS | Belgium, Ireland, The Netherlands, England, Italy, Canada, New Zealand | 21 | Y | N | All inpatients | Cluster randomised trial (prospective) | 18 (6 pre, 12 post) |
Con: 34 (0.73) |
Con: 91 (0.96) |
OR=0.95 (0.48 to 1.86) |
0.88 | 23 | |
| Int: 33 (1.24) |
Int: 56 (1.12) |
|||||||||||||||||
| Cardiac arrest | ||||||||||||||||||
| Cardiac arrests on ward (per 1000 admissions) | Tibballs 200513 | ✓ | ✓ | ✓ | Melbourne Activation Criteria | Australia | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 53 (41 before, 12 after) |
20 (0.19) |
4 (0.11) |
RR=0.58 (0.20 to 1.70) |
0.33 | 10 | |
| Cardiopulmonary arrests (per 1000 non-ICU patient-days) | Brilli 200715 | ✓ | ✓ | ✓ | Paediatric medical emergency team triggering criteria (a) | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 27 (15 before, 12 after) |
7 (0.08) |
2 (0.04) |
RR=0.50 (0.10 to 2.42)† |
0.11 | 14 | |
| Ward cardiac arrest rate (per 1000 ward admissions) | Hanson 201061 | ✓ | ✓ | ✓ | Not described | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (retrospective) | 36 (24 before, 12 after) |
11 (1.27) |
2 (0.45) |
RR=0.35 (0.08 to 1.58)† |
0.13 | 18 | |
| Ward cardiopulmonary arrests (per 1000 patient-days) | Hunt 200816 | ✓ | ✓ | Paediatric medical emergency team triggering criteria | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 24 (12 before, 12 after) |
5 (0.10) |
5 (0.10) |
RR=0.98 (0.22 to 4.24) |
0.97 | 17 | ||
| Preventable cardiac arrests (per 1000 admissions) | Tibballs 200962 | ✓ | ✓ | ✓ | Melbourne Activation Criteria | Australia | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 89 (41 before, 48 after) |
17 (0.16) |
10 (0.07) |
RR=0.45 (0.20 to 0.97) |
0.04 | 15 | |
| Unexpected cardiac arrests (per 1000 admissions) | Tibballs 200962 | ✓ | ✓ | ✓ | Melbourne Activation Criteria | Australia | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 89 (41 before, 48 after) |
20 (0.19) |
24 (0.17) |
RR=0.91 (0.50 to 1.64) |
0.75 | 15 | |
| Actual cardiopulmonary arrests (per 1000 ward admissions) | Kotsakis 201163 | ✓ | ✓ | Modified Melbourne Activation Criteria | Canada | 4 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
69 (1.9) |
66 (1.8) |
RR=0.95 (0.76 to 1.96) | 0.68 | 18 | ||
| Near cardiopulmonary arrests (per 1000 admissions) | Kotsakis 201163 | ✓ | ✓ | Modified Melbourne Activation Criteria | Canada | 4 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
123 (3.4) |
67 (1.9) |
RR=0.54 (0.52 to 0.57) |
<0.001 | 18 | ||
| Cardiac arrests on ward (per 1000 non-ICU patient-days) | Bonafide 201465 | ✓ | ✓ | Bedside PEWS | USA | 1 | Y | N | All inpatients | Interrupted time series study (prospective) | 59 (32 before, 27 after) |
6† (0.03) |
2† (0.01) |
RR=0.36 (0.07 to 1.78)† |
0.21 | 23 | ||
| Cardiac arrests (per 1000 patient-days) | Parshuram 201864 | ✓ | ✓ | ✓ | Bedside PEWS | Belgium, Ireland, The Netherlands, England, Italy, Canada, New Zealand | 21 | Y | N | All inpatients | Cluster randomised trial (prospective) | 18 (six pre, 12 post) |
Con: 18 (0.11) |
Con: 32 (0.10) |
RR=1.02 (0.65 to 1.62) |
0.92 | 23 | |
| Int: 15 (0.12) |
Int: 27 (0.11) |
|||||||||||||||||
| Respiratory arrest | ||||||||||||||||||
| Ward respiratory arrests (per 1000 patient-days) | Hunt 200816 | ✓ | ✓ | Paediatric medical emergency team triggering criteria | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 24 (12 before, 12 after) |
11 (0.23) |
3 (0.06) |
RR=0.27 (0.07 to 0.95) |
0.04 | 17 | ||
| Cardiac or respiratory arrest | ||||||||||||||||||
| Cardiac or respiratory arrest (per 1000 discharges) | Zenker 200760 | ✓ | ✓ | RRT activation criteria* | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 34 (23 before, 11 after) |
180 (7.98) |
60 (5.13) |
RR=0.64 (0.48 to 0.86)† |
0.19 | 12 | ||
| Code calls (per 1000 non-ICU patient-days) | Brilli 200715 | ✓ | ✓ | ✓ | Paediatric medical emergency team triggering criteria (a) | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 27 (15 before, 12 after) |
25 (0.27) |
6 (0.11) |
RR=0.42 (0.17 to 1.03)† |
0.06† | 14 | |
| Code calls (per 1000 non-ICU patient-days) | Sharek 200717 | ✓ | ✓ | ✓ | Paediatric RRT triggering criteria | USA | 1 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 84 (67 before, 17 after) |
53 (0.52) |
5 (0.15) |
RR=0.29 (0.10 to 0.65) |
0.008 | 15 | |
| Code calls (per 1000 admissions) | Anwar-al-Haque 201018 | ✓ | ✓ | Paediatric RRT triggering criteria (b) | Pakistan | 1 | Y | N | All inpatients | Uncontrolled before-after study (retrospective) | 18 (9 before, 9 after) |
26 (5.25) |
12 (2.73) |
RR=0.52 (0.26 to 1.03) |
0.06 | 6 | ||
| Calls for urgent review/assistance | ||||||||||||||||||
| Urgent calls to respiratory therapist (per 1000 patient-days) | Parshuram 201170 | ✓ | ✓ | ✓ | Bedside PEWS | Canada | 1 | N | N | All inpatients | Uncontrolled before-after study (prospective) | 8 (3 before, 5 after) |
8 (9.5) |
8 (3.4) |
RR=0.36 (0.13 to 0.95)† |
0.04† | 23 | |
| Urgent calls to paediatrician (per 1000 patient-days) | Parshuram 201170 | ✓ | ✓ | ✓ | Bedside PEWS | Canada | 1 | N | N | All inpatients | Uncontrolled before-after study (prospective) | 8 (3 before, 5 after) |
19 (22.6) |
12 (5.1) |
RR=0.23 (0.11 to 0.46)† |
<0.0001 | 23 | |
| Code blue calls on the ward (per 1000 admissions) | Kotsakis 201163 | ✓ | ✓ | Modified Melbourne Activation Criteria | Canada | 4 | Y | N | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
210 (3.75) |
150 (2.70) |
RR=0.71 (0.61 to 0.83) |
<0.0001 | 18 | ||
| Urgent calls to outreach team (per 1000 admissions) | Duns 201466 | ✓ | Between the Flags tool* | Australia | 1 | Y | Y | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
1058 (39.5) |
2120 (76.0) |
RR=1.92 (1.79 to 2.07)† |
0.02 | 7 | |||
| RRT calls (per 1000 patient-days) | Panesar 201471 | ✓ | Modified Brighton PEWS (e) | USA | 1 | Y | Y | All inpatients | Uncontrolled before-after study (retrospective) | 42 (18 before, 24 after) |
44 (3.14) |
69 (4.23) |
RR=1.35 (0.92 to 1.96)† |
0.11 | 15 | |||
| RRT calls (per 1000 patient days) | Douglas 201672 | ✓ | ✓ | ✓ | Modified Brighton PEWS (b) | USA | 1 | Y | Y | All inpatients | Uncontrolled before-after study (retrospective) | 24 (12 before, 12 after) |
194 (6.17) |
292 (9.80) |
RR=1.59 (1.33 to 1.90)† |
<0.001 | 12 | |
| Code calls (per 1000 patient days) | Douglas 201672 | ✓ | ✓ | ✓ | Modified Brighton PEWS (b) | USA | 1 | Y | Y | All inpatients | Uncontrolled before-after study (retrospective) | 24 (12 before, 12 after) |
31 (0.98) |
20 (0.67) |
RR=0.68 (0.39 to 1.19)† |
0.21 | 12 | |
| PICU transfers | ||||||||||||||||||
| Transfers from ward to other specialist units (per 1000 patient-days) | Parshuram 201170 | ✓ | ✓ | ✓ | Bedside PEWS | Canada | 1 | N | N | All inpatients | Uncontrolled before-after study (prospective) | 8 (3 before, 5 after) |
5 (5.9) |
19 (8.1) |
RR=1.37 (0.51 to 3.63)† |
0.54† | 23 | |
| Clinical deterioration events on ward prior to transfer to specialist unit (per 1000 patient-days) | Parshuram 201170 | ✓ | ✓ | ✓ | Bedside PEWS | Canada | 1 | N | N | All inpatients | Uncontrolled before-after study (prospective) | 8 (3 before, 5 after) |
2 (2.4) |
1 (0.43) |
RR=0.18 (0.02 to 1.97)† |
0.16† | 23 | |
| PICU transfers (per 1000 admissions) | Duns 201466 | ✓ | Between the Flags tool* | Australia | 1 | Y | Y | All inpatients | Uncontrolled before-after study (prospective) | 48 (24 before, 24 after) |
350 (13.1) |
364 (13.1) |
RR=1.00 (0.86 to 1.16)† |
0.98 | 7 | |||
| Unplanned PICU transfers from ward (per 1000 non-ICU patient-days) | Bonafide 201465 | ✓ | ✓ | Bedside PEWS | USA | 1 | Y | N | All inpatients | Interrupted time series study (prospective) | 59 (32 before, 27 after) |
874 (4.54) |
936 (5.25) |
IRR=0.73 (0.46 to 1.14) |
0.16 | 23 | ||
| Unplanned transfers to PICU from ward (per 1000 patient-days) | Agulnik 201767 | ✓ | ✓ | Children’s Hospital Cardiac Early Warning Score | Guatemala | 1 | Y | N | Oncology unit | Uncontrolled before-after study (retrospective) | 24 (12 before, 12 after) |
157 (9.3) |
130 (6.5) |
RR=0.70 (0.56 to 0.88)† |
0.003 | 19 | ||
| Urgent PICU admissions (per 1000 patient-days) | Parshuram 201864 | ✓ | ✓ | ✓ | Bedside PEWS | Belgium, Ireland, The Netherlands, England, Italy, Canada, New Zealand | 21 | Y | N | All inpatients | Cluster randomised trial (prospective) | 18 (6 pre, 12 post) |
Con: 652 (4.01) |
Con: 1178 (3.83) |
RR=0.95 (0.82 to 1.09) |
0.45 | 23 | |
| Int: 469 (3.62) |
Int: 828 (3.29) |
|||||||||||||||||
| PICU outcomes | ||||||||||||||||||
| Critical deterioration events after PICU transfer (per 1000 non-ICU patient-days) | Bonafide 201465 | ✓ | ✓ | Bedside PEWS | USA | 1 | Y | N | All inpatients | Interrupted time series study (prospective) | 59 (32 before, 27 after) |
260† (1.35) |
282† (1.58) |
IRR=0.38 (0.20 to 0.75) |
0.01 | 23 | ||
| Mechanical ventilation within 1 hour of unplanned PICU transfer (per unplanned transfer to PICU) | Bonafide 201465 | ✓ | ✓ | Bedside PEWS | USA | 1 | Y | N | All inpatients | Interrupted time series study (prospective) | 59 (32 before, 27 after) |
45 (5.1) |
42 (4.5) |
RR=0.87 (0.58 to 1.31)† |
0.51 | 23 | ||
| Mechanical ventilation within 12 hours of unplanned PICU transfer (per unplanned transfer to PICU) | Bonafide 201465 | ✓ | ✓ | Bedside PEWS | USA | 1 | Y | N | All inpatients | Interrupted time series study (prospective) | 59 (32 before, 27 after) |
112 (12.8) |
103 (11.0) |
IRR=0.17 (0.07 to 0.44) |
<0.001 | 23 | ||
| Vasopressors within 1 hour of unplanned PICU transfer (per unplanned transfer to PICU) | Bonafide 201465 | ✓ | ✓ | Bedside PEWS | USA | 1 | Y | N | All inpatients | Interrupted time series study (prospective) | 59 (32 before, 27 after) |
41 (4.7) |
16 (1.7) |
RR=0.36 (0.21 to 0.64)† |
<0.001 | 23 | ||
| Vasopressors within 12 hours of unplanned PICU transfer (per unplanned transfer to PICU) | Bonafide 201465 | ✓ | ✓ | Bedside PEWS | USA | 1 | Y | N | All inpatients | Interrupted time series study (prospective) | 59 (32 before, 27 after) |
71 (8.1) |
57 (6.1) |
IRR=0.20 (0.06 to 0.62) |
0.006 | 23 | ||
| Invasive ventilation in PICU (per emergency PICU admission) | Sefton 201568 | ✓ | ✓ | ✓ | Modified Bristol PEWT (a) | UK | 1 | Y | N | All PICU admissions | Controlled before-after study (retrospective) | 24 (12 before, 12 after) |
118 (75.2) |
104 (62.7) |
RR=0.83 (0.72 to 0.97)† |
0.002 | 16 | |
| Inotropes in PICU (per emergency PICU admission) | Sefton 201568 | ✓ | ✓ | ✓ | Modified Bristol PEWT (a) | UK | 1 | Y | N | All PICU admissions | Controlled before-after study (retrospective) | 24 (12 before, 12 after) |
50 (31.8) |
40 (24.1) |
RR=0.76 (0.53 to 1.08)† |
0.12 | 16 | |
| Intubation within 24 hours of PICU admission (per 1000 patient-days) | Agulnik 201767 | ✓ | ✓ | Children’s Hospital Cardiac Early Warning Score | Guatemala | 1 | Y | N | Oncology unit | Uncontrolled before-after study (retrospective) | 24 (12 before, 12 after) |
11 (0.65) |
18 (0.90) |
RR=1.38 (0.65 to 2.92)† |
0.46 | 19 | ||
| Vasopressors within 24 hours of PICU admission (per 1000 patient-days) | Agulnik 201767 | ✓ | ✓ | Children’s Hospital Cardiac Early Warning Score | Guatemala | 1 | Y | N | Oncology unit | Uncontrolled before-after study (retrospective) | 24 (12 before, 12 after) |
29 (1.72) |
37 (1.86) |
RR=1.08 (0.66 to 1.75)† |
0.60 | 19 | ||
| Mechanical ventilation during PICU admission (per PICU admission) | Kolovos 201869 | ✓ | ✓ | RRT activation criteria* | USA | 1 | Y | N | All unplanned PICU admissions | Uncontrolled before-after study (retrospective) | 78 (42 before, 36 after) |
285 (25.98) |
233 (22.09) |
RR=0.85 (0.73 to 0.99)† |
0.03† | 12 | ||
| Intubation within 1 hour of PICU admission (per PICU admission) | Kolovos 201869 | ✓ | ✓ | RRT activation criteria* | USA | 1 | Y | N | All unplanned PICU admissions | Uncontrolled before-after study (retrospective) | 78 (42 before, 36 after) |
49 (4.47) |
88 (8.34) |
RR=1.87 (1.33 to 2.62) |
0.0003 | 12 | ||
| Significant clinical deterioration events (per 1000 patient-days) | Parshuram 201864 | ✓ | ✓ | ✓ | Bedside PEWS | Belgium, Ireland, The Netherlands, England, Italy, Canada, New Zealand | 21 | Y | N | All inpatients | Cluster randomised trial (prospective) | 18 (6 pre, 12 post) |
Con: 144 (0.89) |
Con: 259 (0.84) |
RR=0.77 (0.61 to 0.97) |
0.03 | 23 | |
| Int: 80 (0.62) |
Int: 127 (0.50) |
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P values in bold denote statistical significance (<0.05).
A critical deterioration event is defined as transfer to the ICU followed by non-invasive or invasive mechanical ventilation or vasopressor infusion within 12 hours.65
*Indicates a PTTT not described or validated in the published literature.
†Data calculated by research team, based on data presented in the journal article. All data calculated via https://www.medcalc.org.
Con, control group; ED, emergency department; ICU, intensive care unit; Int, intervention group; IRR, incident risk ratio; MET, medical emergency team; N/A, not available; PICU, paediatric intensive care unit; PTTT, paediatric track and trigger tool; RR, relative risk; RRT, rapid response team.