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040 Prehospital national early warning score predicts patient disposition also in japan
  1. Takuro Endo,
  2. Shigeki Fujitani,
  3. Yasuhiko Taira
  1. St. Mariana University School of Medicine


The National early warning score (NEWS) was originally developed in the UK for hospitalized patients. We examined if NEWS can be applied for emergency transported patients in Japan.

We assessed the patients transported to one hospital between April 2017 to March 2018. We calculated NEWS from the vitals recorded by ambulance staff. Emergency department (ED) disposition data were categorized into the following groups depending on their outcome: discharged from ED, admitted to a ward, admitted to the intensive care unit or died in ED. We assessed the predictive performance of the NEWS for combined patient dispositions using receiver operating characteristics curves, from which possible cut-off values for risk categorizations were derived. Patient dispositions were compared between NEWS-based three categories adjusting for age, gender and presence of traumatic injury.

Results Of 2,847 patients, mean (±standard deviation) NEWS of patients who discharged from ED (n=1330), admitted to a ward (n=1263), admitted to the ICU (n=232), and died in ED (n=22) were 3.7±2.9, 6.3±3.8, 9.4±4.0, 11.7±2.9, respectively. Prehospital NEWS’s C-statistics (95% confidence interval) for admission to a ward/the ICU or death in ED was 0.733(0.715–0.751), admission to the ICU or death in ED was 0.807 (0.780–0.833), and death in ED was 0.900 (0.868–0.933). After adjusting for age, gender and trauma, odds ratio (95% confidence interval) for admission to the ICU or death in ED of high-risk NEWS category (≥7) was 13.8 (8.9–21.6) and middle category (5 or 6) was 4.2 (2.5–7.1), each compared to low-risk category (≤4).

Conclusion Our study shows prehospital NEWS can identify patients at risk of adverse outcomes also in Japan.

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