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Earlier ICU Transfer after CONCERN Early Warning System Score Escalation Reduced Sepsis-related Mortality: Results from a Multi-site Pragmatic Cluster Randomized Controlled Trial

AMIA Annu Symp Proc. 2025 May 22;2024:705-714. eCollection 2024.

ABSTRACT

Early recognition and timely escalation of care are critical for improving sepsis outcomes. This post-hoc analysis of a multi-site clinical trial examined whether the timing of ICU transfer following CONCERN Early Warning System (EWS) score escalation was associated with in-hospital mortality among patients later diagnosed with sepsis. Among 54 patients with CONCERN score changes prior to unanticipated ICU transfer, shorter score-change-to-ICU-transfer time intervals were significantly associated with lower odds of in-hospital death. A 36-hour threshold emerged as a potential inflection point; all patients transferred after this time interval died in the hospital. No significant differences were observed in the ICU-arrival-to-sepsis time interval between early and late transfers. These findings highlight the importance of acting promptly on early warning systems and suggest that CONCERN EWS may offer a meaningful lead time for intervention improving outcomes for sepsis patients.

PMID:41726485 | PMC:PMC12919569