Martin Spångfors1,2, Gitte Bunkenborg3,4,5, Mats Molt1, Karin Samuelson1,6. 1. Department of Clinical Sciences Lund, Anesthesiology and Intensive Care, Faculty of Medicine, Lund University, Lund, Sweden. 2. Department of Anaesthesiology & Intensive Care, Hospital of Kristianstad, Region Skane, Sweden. 3. Department of Anaesthesiology, Copenhagen University Hospital, Hvidovre, Denmark. 4. Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Malmö, Sweden. 5. Department of Anesthesiology, Holbaek University Hospital, Zealand Region, Denmark. 6. Department of Health Sciences, Lund University, Lund, Sweden.
Abstract
AIMS AND OBJECTIVES: To evaluate whether the scale used for assessment of hospital ward patients could predict in-hospital and 30-day mortality amongst those with deviating vital signs; that is, that patients classified as medium or high risk would have increased risk of in-hospital and 30-day mortality compared to patients with low risk. BACKGROUND: The National Early Warning Score (NEWS) is a widely adopted scale for assessing deviating vital signs. A clinical risk scale that comes with the NEWS divides the risk for critical illness into three risk categories, low, medium and high. DESIGN: Retrospective analysis of vital sign data. METHODS: Logistic regression models for age-adjusted in-hospital and 30-day mortality were used for analyses of 1,107 patients with deviating vital signs. RESULTS: Patients classified as medium or high risk by NEWS experienced a 2.11 or 3.40 increase, respectively, in odds of in-hospital death (95% CI: 1.27-3.51, p = 0.004% and 95% CI: 1.90-6.01, p < 0.001) compared to low-risk patients. Moreover, those with NEWS medium or high risk were associated with a 1.98 or 3.19 increase, respectively, in odds of 30-day mortality (95% CI: 1.32-2.97, p = 0.001% and 95% CI: 1.97-5.18, p < 0.001). CONCLUSION: The NEWS risk classification seems to be a reliable predictor of mortality on patients in hospital wards. RELEVANCE TO CLINICAL PRACTICE: The NEWS risk classification offers a simple way to identify deteriorating patients and can aid the healthcare staff to prioritise amongst patients.
AIMS AND OBJECTIVES: To evaluate whether the scale used for assessment of hospital ward patients could predict in-hospital and 30-day mortality amongst those with deviating vital signs; that is, that patients classified as medium or high risk would have increased risk of in-hospital and 30-day mortality compared to patients with low risk. BACKGROUND: The National Early Warning Score (NEWS) is a widely adopted scale for assessing deviating vital signs. A clinical risk scale that comes with the NEWS divides the risk for critical illness into three risk categories, low, medium and high. DESIGN: Retrospective analysis of vital sign data. METHODS: Logistic regression models for age-adjusted in-hospital and 30-day mortality were used for analyses of 1,107 patients with deviating vital signs. RESULTS:Patients classified as medium or high risk by NEWS experienced a 2.11 or 3.40 increase, respectively, in odds of in-hospital death (95% CI: 1.27-3.51, p = 0.004% and 95% CI: 1.90-6.01, p < 0.001) compared to low-risk patients. Moreover, those with NEWS medium or high risk were associated with a 1.98 or 3.19 increase, respectively, in odds of 30-day mortality (95% CI: 1.32-2.97, p = 0.001% and 95% CI: 1.97-5.18, p < 0.001). CONCLUSION: The NEWS risk classification seems to be a reliable predictor of mortality on patients in hospital wards. RELEVANCE TO CLINICAL PRACTICE: The NEWS risk classification offers a simple way to identify deteriorating patients and can aid the healthcare staff to prioritise amongst patients.
Keywords:
Early Warning Score; Medical Emergency Team; National Early Warning Score; critical care; critical care outreach; hospital mortality; in-hospital cardiac arrest; vital signs
Authors: J'Belle Foster; Diana Mendez; Ben J Marais; Justin T Denholm; Dunstan Peniyamina; Emma S McBryde Journal: Trop Med Infect Dis Date: 2022-09-19