Highlight
– Real‑time automated clinical deterioration alerts were associated with a 40% relative reduction in in‑hospital cardiac arrests (RR 0.60; 95% CI 0.43–0.85) in alert‑eligible ward patients.
– No statistically significant overall reduction in hospital mortality was observed (RR 0.80; 95% CI 0.62–1.05), though structured escalation pathways may increase benefit.
– ICU length of stay was reduced in limited analyses; effects on unplanned ICU transfers and hospital length of stay were inconsistent.
