The predictive power of the National Early Warning Score (NEWS) 2, as compared to NEWS, among patients assessed by a Rapid response team: A prospective multi-centre trial

Resuscitation Plus

Martin Spångfors¹  Martin Jonsson²  Thomas Kahan³  Eva Joelsson-Alm⁴  Araz Rawshani⁵  Johan Engdahl⁶  Anna Thorén⁷  Therese Djärv⁸ 

[1] Corresponding author at: Department of Clinical Physiology, Danderyd University Hospital, SE-182 88 Stockholm, Sweden.;Department of Anaesthesia and Intensive Care, Kristianstad Hospital, SE-291 89 Kristianstad, Sweden;Department of Anaesthesia and Intensive Care, Södersjukhuset, SE-118 83 Stockholm, Sweden;Department of Clinical Physiology, Danderyd University Hospital, SE-182 88 Stockholm, Sweden;Department of Clinical Science and Education, Karolinska Institutet, SE-118 83 Stockholm, Sweden;Department of Clinical Sciences, Lund University, SE-221 84 Lund, Sweden;Department of Medicine Solna, Centre for Resuscitation Science, Karolinska Institutet, SE-171 77 Stockholm, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, SE-405 30 Gothenburg, Sweden;

关键词: National early warning score;    National early warning score 2;    Vital signs;    Rapid response team;    Mortality;    In-hospital cardiac arrest;   

DOI  :  

来源: DOAJ

【 摘 要 】

Aim: Early identification of patients at risk of serious adverse events (SAEs) is of vital importance, yet it remains a challenging task. We investigated the predictive power of National Early Warning Score (NEWS) 2, as compared to NEWS, among patients assessed by a Rapid response team (RRT). Methods: Prospective, observational cohort study on 898 consecutive patients assessed by the RRTs in 26 Swedish hospitals. For each patient, NEWS and NEWS 2 scores were uniformly calculated by the study team. The associations of NEWS and NEWS 2 scores with unanticipated admissions to Intensive care unit (ICU), mortality and in-hospital cardiac arrests (IHCA) within 24 h, and the composite of these three events were investigated using logistic regression. The predictive power of NEWS and NEWS 2 was assessed using the area under the receiver operating characteristic (AUROC) curves. Results: The prognostic accuracy of NEWS/NEWS 2 in predicting mortality was acceptable (AUROC 0.69/0.67). In discriminating the composite outcome and unanticipated ICU admission, both NEWS and NEWS 2 were relatively weak (AUROC 0.62/0.62 and AUROC 0.59/0.60 respectively); for IHCA the performance was poor. There were no differences between NEWS and NEWS 2 as to the predictive power. Conclusion: The prognostic accuracy of NEWS 2 to predict mortality within 24 h was acceptable. However, the prognostic accuracy of NEWS 2 to predict IHCA was poor. NEWS and NEWS 2 performed similar in predicting the risk of SAEs but their performances were not sufficient for use as a risk stratification tool in patients assessed by a RRT.

【 授权许可】

Unknown