A Prospective Validation of National Early Warning Score in Emergency Intensive Care Unit Patients at Beijing

Abstract

Introduction National Early Warning Score (NEWS) was launched in 2012 by the Royal College of Physicians in UK with an aim to improve the assessment of critical patients and timely detection of clinical deterioration. Objective To assess the performance of NEWS in emergency intensive care unit (EICU) patients in Beijing, PROC. Design prospective cohort study. Setting EICU in a university hospital. Methods The inclusion criteria were patients who stayed in the EICU beds under Department of Emergency Medicine, Xuanwu Hospital of Capital Medical University. Data of patients on admission were collected and calculated NEWS. Main outcome measure was death within 24 hours. The ability to predict mortality was assessed by area under the receiver operating characteristic curve (AUROC) analysis. Results Data on 540 consecutive EICU patients were collected from 1st January, 2013 to 31st March, 2013. Scores of 7 or more were associated with increased risk of death (OR=16.8; 95% CI 6.6-42.9). The AUROC for death within 24 h of admission was 0.85 (95% CI 0.79-0.90). Conclusions NEWS is applicable and feasible for EICU patients in Beijing. This study shows that the prediction power of NEWS for death within 24 hours of acutely ill patients attending Xuan Wu Hospital is comparable to that reported for the United Kingdom patients. (Hong Kong j.emerg.med. 2015;22:137-144)

Evaluation of the Risk Prediction Tools for Patients With Coronavirus Disease 2019 in Wuhan, China: A Single-Centered, Retrospective, Observational Study*

“…NEWS is a validated clinical assessment tool developed by the Royal College of Physicians in the United Kingdom ( 9 – 11 ). NEWS comprises respiratory rate, oxygen saturation, temperature, systolic blood pressure, heart rate, and level of consciousness (Supplementary Table 1, Supplemental Digital Content 1, http://links.lww.com/CCM/F704 ).…”

The effectiveness of physiologically based early warning or track and trigger systems after triage in adult patients presenting to emergency departments: a systematic review

“…The single effectiveness study was rated as having high ROB [ 28 ]. Eight studies that developed and validated a system (in the same sample) were rated as having low ( n = 6) [ 29 – 34 ] and unclear (n = 2) [ 35 , 36 ] ROB. The 28 studies that validated an existing system in a new cohort were judged as having an overall low ( n = 16) [ 37 – 52 ], unclear ( n = 9) [ 18 , 53 – 60 ] and high ROB ( n = 3) [ 61 – 63 ].…”

“…The 28 studies that validated an existing system in a new cohort were judged as having an overall low ( n = 16) [ 37 – 52 ], unclear ( n = 9) [ 18 , 53 – 60 ] and high ROB ( n = 3) [ 61 – 63 ]. The domains of selection bias and factor measurement were most commonly rated as unclear ROB because they did not specify the methods of sampling ( n = 10) [ 18 , 36 – 38 , 47 , 48 , 54 , 58 – 60 ] or did not state cut-off values used ( n = 12) [ 31 , 33 – 35 , 42 , 46 , 49 , 57 , 58 , 60 , 61 , 63 ]. One study also did not pre-specify the outcomes clearly [ 59 ].…”

“…Manchester triage system I-III, Patient acuity category scale 1 or 2) or were admitted to the resuscitation room. In predicting mortality, the AUROC for the MEWS ranged from 0.63 to 0.75 [ 36 , 37 , 44 , 57 ], from 0.70–0.77 for REMS [ 31 , 37 ], 0.77–0.87 for NEWS [ 53 ], 0.90 for PEDS, 0.83 for APACHE II, and 0.77 for RTS [ 31 ]. Predicting ICU admission, the AUROC were 0.54 [ 37 ] and 0.49 [ 44 ] for MEWS and 0.59 for REMS [ 37 ], while to predict hospital admission the AUROC for NEWS was 0.66–0.70 [ 53 ].…”

Early warning score validation methodologies and performance metrics: a systematic review

“…16 of the studies performed an internal validation, where a proportion of the entire study dataset was used to develop the EWS (training set), with the remaining proportion was used for validation (validation set) [9,11,17,18,20,22,24,28,32,34,35,38,39,41,44,46,57]. Varying proportion sizes were used for the validation set ranging from 25.0 to 100%.…”