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This may be explained by a lack of awareness on patients' impending deterioration by the ward staff, problems in shift handovers, and periods of diminished physician attendance as a consequence of local working organization.
Our results revealed that the EWS objectively correlates with patients' impending deterioration and may predict admission into higher level of care units, length of stay, and in-hospital mortality.
More precise assessment would lead to enhanced measurement of the rate of decline and improve predication of impending deterioration.
A landmark study from East London 3 identified physiological evidence of impending deterioration some hours before collapse in a substantial proportion of patients admitted to intensive care during an emergency.
While standard physiologic parameters in the ED were unable to differentiate sepsis patients who developed increased organ failure, a decreased LF/HF ratio and DFA, measurements of variability representing physiologic reserve, was associated with impending deterioration.
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At the same time, hypoglycemia among diabetic patients in the general ward could be interpreted as a warning sign of an impending clinical deterioration.
This study [ 6] showed that it is important that respiratory rate be monitored, and that it should be recorded regularly in ward patients because an increased rate is a possible sign of impending clinical deterioration.
This comment helped me understand the difference between my perspective as a healthy person and my mother's experience as someone no longer aware of her deterioration and impending death.
On July 7, hemorrhagic fever was included among other infectious causes in the differential diagnosis because of rapid clinical deterioration and impending liver failure.
In general, surgery for MSCC should be proposed for selected patients, i.e. if there are diagnostic doubts, if stabilization of the vertebral column is required, in case of (impending) sphincter dysfunction, in case of deterioration of motor function during RT, after previous longer-course RT, or if collapse of the vertebral body causes bone impingement on the spinal cord or the nerve roots.
After this compelling introduction, the narrative moves swiftly to the impending defeat of April 1945, and the shocking physical deterioration of the Führer's final days, especially the drugs administered to him by a sinister cabal of Nazi doctors, to the point at which he became, in Trevor-Roper's words, "a physical wreck".
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com