Elsevier

Journal of Critical Care

Volume 47, October 2018, Pages 222-226
Journal of Critical Care

Outcome/Prediction
Evaluation of the efficacy of the National Early Warning Score in predicting in-hospital mortality via the risk stratification

https://doi.org/10.1016/j.jcrc.2018.07.011Get rights and content
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open access

Highlights

  • NEWS is a simple, useful, and rapid bedside tool for predicting in-hospital mortality.

  • The activation of RRT had to consider other clinical factors as well as screening tools to improve clinical outcomes.

  • Old age, medical reasons for admission, and cancer were major factors in this study.

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.

Abbreviations

APACHE
The Acute Physiology and Chronic Health Evaluation
SAPS
The Simplified Acute Physiology Score
NEWS
National Early Warning Score
ICU
intensive care unit
RRT
rapid response team
EMR
electronic medical record
AUC
area under the curve
HR
hazard ratio
CI
confidence interval
AUC
the area under the curve
AVPU
Alert, Voice, Pain, Unresponsive

Keywords

National Early Warning Score
Rapid response system
Hospital mortality
Screening
Prognosis

Cited by (0)

Declarations of interest: none.