Validation of the VitalPAC™ Early Warning Score (ViEWS) in acutely ill medical patients attending a resource-poor hospital in sub-Saharan Africa

BackgroundThe VitalPAC™ Early Warning Score (ViEWS) has an area under the receiver operator characteristic curve (AUROC) for death of acute unselected medical patients within 24 h of 88% and the UK National Early Warning Scores is based on it. The score's discrimination has been validated on patients in the developed world, but nothing is known of its performance in resource-poor hospitals.MethodsViEWS was validated in 844 acutely ill medical patients admitted to Kitovu Hospital, Masaka, Uganda.ResultsThe AUROC for death within 24 h of admission was 88.6% (95% CI 82.5–94.7%). The inability to walk without help was found to be an additional independent predictor of in-hospital mortality, and ViEWS modified to include it had an AUROC for death within 24 h of 91.9% (95% CI 86.5–97.2%).ConclusionThe discrimination of ViEWS in a resource poor sub-Saharan Africa hospital is the same as in the developed world. Inability to walk without help was found to be an additional independent predictor of mortality.