Supattra Uppanisakorn1, Rungsun Bhurayanontachai2, Jaruwan Boonyarat3, Julawan Kaewpradit4. 1. Medical Intensive Care Unit, Songklanagarind Hospital, Hat Yai, Songkhla 90110, Thailand. Electronic address: ssupattr@medicine.psu.ac.th. 2. Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. Electronic address: brungsun@medicine.psu.ac.th. 3. Medical Intensive Care Unit, Songklanagarind Hospital, Hat Yai, Songkhla 90110, Thailand. Electronic address: bjaruwan@medicine.psu.ac.th. 4. Medical Intensive Care Unit, Songklanagarind Hospital, Hat Yai, Songkhla 90110, Thailand. Electronic address: juju_nus@hotmail.com.
Abstract
OBJECTIVE: This study aims to determine the ability of the National Early Warning Score at ICU discharge (NEWSdc) to predict the development of clinical deterioration within 24h. METHODS: A prospective observational study was conducted. The NEWS was immediately recorded before discharge (NEWSdc). The development of early clinical deterioration was defined as acute respiratory failure or circulatory shock within 24h of ICU discharge. The discrimination of NEWSdc and the best cut off value of NEWSdc to predict the early clinical deterioration was determined. RESULTS: Data were collected from 440 patients. The incidence of early clinical deterioration after ICU discharge was 14.8%. NEWSdc was an independent predictor for early clinical deterioration after ICU discharge (OR 2.54; 95% CI 1.98-3.26; P<0.001). The AUROC of NEWSdc was 0.92±0.01 (95% CI 0.89-0.94, P<0.001). A NEWSdc>7 showed a sensitivity of 93.6% and a specificity of 82.2% to detect an early clinical deterioration after ICU discharge. CONCLUSION: Among critically ill patients who were discharged from ICU, a NEWSdc>7 showed the best sensitivity and specificity to detect early clinical deterioration 24h after ICU discharge.
OBJECTIVE: This study aims to determine the ability of the National Early Warning Score at ICU discharge (NEWSdc) to predict the development of clinical deterioration within 24h. METHODS: A prospective observational study was conducted. The NEWS was immediately recorded before discharge (NEWSdc). The development of early clinical deterioration was defined as acute respiratory failure or circulatory shock within 24h of ICU discharge. The discrimination of NEWSdc and the best cut off value of NEWSdc to predict the early clinical deterioration was determined. RESULTS: Data were collected from 440 patients. The incidence of early clinical deterioration after ICU discharge was 14.8%. NEWSdc was an independent predictor for early clinical deterioration after ICU discharge (OR 2.54; 95% CI 1.98-3.26; P<0.001). The AUROC of NEWSdc was 0.92±0.01 (95% CI 0.89-0.94, P<0.001). A NEWSdc>7 showed a sensitivity of 93.6% and a specificity of 82.2% to detect an early clinical deterioration after ICU discharge. CONCLUSION: Among critically illpatients who were discharged from ICU, a NEWSdc>7 showed the best sensitivity and specificity to detect early clinical deterioration 24h after ICU discharge.
Authors: Ahmed Naji Balshi; Basim Mohammed Huwait; Alfateh Sayed Nasr Noor; Abdulrahman Mishaal Alharthy; Ahmed Fouad Madi; Omar Elsayed Ramadan; Abdullah Balahmar; Huda A Mhawish; Bobby Rose Marasigan; Alva Minette Alcazar; Muhammad Asim Rana; Waleed Tharwat Aletreby Journal: Rev Bras Ter Intensiva Date: 2020-07-13
Authors: Marco A F Pimentel; Oliver C Redfern; Stephen Gerry; Gary S Collins; James Malycha; David Prytherch; Paul E Schmidt; Gary B Smith; Peter J Watkinson Journal: Resuscitation Date: 2018-10-01 Impact factor: 5.262