Comparing the prehospital NEWS with in-hospital ESI in predicting 30-day severe outcomes in emergency patients

BMC Emergency Medicine

Ehsan Karimialavijeh¹  Atefeh Abdollahi¹  Peyman Saberian¹  Maryam Modaber²  Parisa Hasani-Sharamin² 

[1] Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences;Tehran Emergency Medical Service Center;

关键词: Emergency medical services;    Early warning score;    Triage;    Emergency severity index;    Patient outcome;    Smartphone;   

DOI  :  10.1186/s12873-022-00598-5

来源: DOAJ

【 摘 要 】

Abstract Background In Iran, the emergency departments (EDs) have largely adopted the emergency severity index (ESI) to prioritize the emergency patients, however emergency medical services (EMS) mainly triage the patients based on the paramedics’ gestalt. The National Early Warning Score (NEWS) is a recommended prehospital triage in the UK. We aimed to compare prehospital NEWS and ED ESI for predicting severe outcomes in emergency patients. Methods An observational study was conducted in a university-affiliated ED between January and April 2021. Adult patients who arrived in the ED by EMS were included. EMS providers calculated the patients' NEWS upon arriving on the scene using an Android NEWS application. In the ED, triage nurses utilized the ESI algorithm to prioritize patients with higher clinical risk. Then, Research nurses recorded patients' 30-day severe outcomes (death or ICU admission). Finally, The prognostic properties of ESI and NEWS were evaluated. Results One thousand forty-eight cases were included in the final analysis, of which 29 (2.7%) patients experienced severe outcomes. The difference between the prehospital NEWS and ED ESI in predicting severe outcomes was not statistically significant (AUC = 0.825, 95% CI: 0.74–0.91 and 0.897, 95% CI, 0.83–0.95, for prehospital NEWS and ESI, respectively). Conclusion Our findings indicated that prehospital NEWS compares favorably with ED ESI in predicting 30-day severe outcomes in emergency patients.

【 授权许可】

Unknown