Young Seok Lee1, Jae Woo Choi2, Yeon Hee Park3, Chaeuk Chung4, Dong Il Park4, Jeong Eun Lee4, Hye Sun Lee5, Jae Young Moon6. 1. Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Medical Center, Guro Hospital, Seoul, Republic of Korea. 2. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Cheongju St. Mary's Hospital, Cheongju, Republic of Korea. 3. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary's Hospital, Daejeon, Republic of Korea. 4. Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea. 5. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea. 6. Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea. Electronic address: jymoon@cnuh.co.kr.
Abstract
PURPOSE: To investigate the efficacy of the National Early Warning Score (NEWS) in predicting in-hospital mortality. MATERIALS AND METHODS: This was a retrospective observational study and the electronic medical records of the patients were reviewed based on NEWS at the time of admission. RESULTS: The performance of NEWS was effective in predicting hospital mortality (area under the curve: 0.765; 95% confidence interval: 0.659-0.846). Based on the Kaplan Meier survival curves, the survival time of patients who are at high risk according to NEWS was significantly shorter than that of patients who are at low risk (p < 0.001). Results of the multivariate Cox proportional hazards regression analysis showed that the hazard ratios of patients who are at medium and high risk based on NEWS were 2.6 and 4.7, respectively (p < 0.001). In addition, our study showed that the combination model that used other factors, such as age and diagnosis, was more effective than NEWS alone in predicting hospital mortality (NEWS: 0.765; combination model: 0.861; p < 0.005). CONCLUSIONS: NEWS is a simple and useful bedside tool for predicting in-hospital mortality. In addition, the rapid response team must consider other clinical factors as well as screening tools to improve clinical outcomes.
PURPOSE: To investigate the efficacy of the National Early Warning Score (NEWS) in predicting in-hospital mortality. MATERIALS AND METHODS: This was a retrospective observational study and the electronic medical records of the patients were reviewed based on NEWS at the time of admission. RESULTS: The performance of NEWS was effective in predicting hospital mortality (area under the curve: 0.765; 95% confidence interval: 0.659-0.846). Based on the Kaplan Meier survival curves, the survival time of patients who are at high risk according to NEWS was significantly shorter than that of patients who are at low risk (p < 0.001). Results of the multivariate Cox proportional hazards regression analysis showed that the hazard ratios of patients who are at medium and high risk based on NEWS were 2.6 and 4.7, respectively (p < 0.001). In addition, our study showed that the combination model that used other factors, such as age and diagnosis, was more effective than NEWS alone in predicting hospital mortality (NEWS: 0.765; combination model: 0.861; p < 0.005). CONCLUSIONS: NEWS is a simple and useful bedside tool for predicting in-hospital mortality. In addition, the rapid response team must consider other clinical factors as well as screening tools to improve clinical outcomes.
Authors: Stephen Gerry; Timothy Bonnici; Jacqueline Birks; Shona Kirtley; Pradeep S Virdee; Peter J Watkinson; Gary S Collins Journal: BMJ Date: 2020-05-20
Authors: Francisco Martín-Rodríguez; Raúl López-Izquierdo; Carlos Del Pozo Vegas; Juan F Delgado-Benito; Carmen Del Pozo Pérez; Virginia Carbajosa Rodríguez; Agustín Mayo Iscar; José Luis Martín-Conty; Carlos Escudero Cuadrillero; Miguel A Castro-Villamor Journal: Emerg Med Int Date: 2019-07-01 Impact factor: 1.112