The National Early Warning Score (NEWS)-2 is an early warning scale that is used in emergency departments to identify patients at risk of clinical deterioration and to help establish rapid and timely management. The objective of this study was to determine the validity and prediction of mortality using the NEWS2 scale for adults in the emergency department of a tertiary clinic in Colombia. A prospective observational study was conducted between August 2018 and June 2019 at the Universidad de La Sabana Clinic. The nursing staff in the triage classified the patients admitted to the emergency room according to Emergency Severity Index and NEWS2. Demographic data, physiological variables, admission diagnosis, mortality outcome, and comorbidities were extracted. Three thousand nine hundred eighty-six patients were included in the study. Ninety-two (2%) patients required intensive care unit management, with a mean NEWS2 score of 7. A total of 158 patients died in hospital, of which 63 were women (40%). Of these 65 patients required intensive care unit management. The receiver operating characteristic curve for NEWS2 had an area of 0.90 (CI 95%: 0.87–0.92). A classification and score equivalency analysis was performed between triage and the NEWS2 scale in terms of mortality. Of the patients classified as triage I, 32.3% died, and those who obtained a NEWS2 score greater than or equal to 10 had a mortality of 38.6%. Among our population, NEWS2 was not inferior in its area under the receiver operating characteristic curve when predicting mortality than triage, and the cutoff point for NEWS2 to predict in-hospital mortality was higher.
La trata de personas (TDP) es un fenómeno criminal creciente que afecta a millones de personas en el mundo. Desde el año 2003, el número de víctimas identificadas y de tratantes condenados ha aumentado a nivel global y en América Latina y el Caribe (ALC). Esto puede ser resultado de un aumento de los casos, de una mayor capacidad para detectar a las víctimas por parte de las autoridades, o de ambos. Con base en fuentes secundarias y discusiones de la Serie de Diálogos Técnicos de Trata de Personas (2020-2022), este documento presenta aspectos clave de la capacidad institucional de los países de ALC para responder a este delito. La Sección 1 presenta un panorama actual de la situación del delito de TDP en ALC y describe cómo las características de este crimen han ido evolucionando en las últimas décadas. La Sección 2 muestra algunas acciones de fortalecimiento de capacidades institucionales que los países de la región han implementado para responder a este flagelo de manera activa y coordinada. La Sección 3 resalta la importancia del abordaje desde una perspectiva integral y multisectorial para responder de manera oportuna, coordinada y sostenible a un fenómeno tan complejo como la TDP. La Sección 4 presenta algunas acciones claves para fortalecer las capacidades de respuesta de las instituciones del sector de seguridad y justicia en la detección, prevención y persecución de la trata de personas, así como para la protección de las víctimas. Por último, algunas iniciativas prometedoras en las áreas clave de prevención, protección y persecución que han realizado los países de la región con el objetivo de prevenir, proteger a las víctimas y perseguir el delito de TDP.
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