&lt;p&gt;National Early Warning Score (NEWS) as Prognostic Triage Tool for Septic Patients&lt;/p&gt;

Almutary, Abdulaziz M.; Althunayyan, Saqer M; Alenazi, Khaled; Alqahtani, Abdulrahman; Alotaibi, Badar Faiz; Ahmed, Marwa Mostafa; Osman, Isam; Kakpuri, Adil; Alanazi, Abdulaziz; Arafat, Mohammed; Almutairi, Abdulmajeed; Bashraheel, Fatma; Almazroua, Faisal

doi:10.2147/idr.s275390

Cited by 22 publications

(23 citation statements)

References 22 publications

(14 reference statements)

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“… 30 , 31 Scoring systems based on a single registration of clinical parameters may have limited accuracy in predicting deterioration. 32 Additionally, more than one in five patients presenting to the ED with suspected infection or sepsis deteriorate within 72 h from admission. 31 Our data revealed that using clinical admission variables alone may result in flawed estimates of the prevalence of sepsis among ED patients and prognostic accuracy of the sepsis scores.…”

Section: Discussionmentioning

confidence: 99%

National Early Warning Score and New-Onset Atrial Fibrillation for Predicting In-Hospital Mortality or Transfer to the Intensive Care Unit in Emergency Department Patients with Suspected Bacterial Infections

Nielsen¹,

Stæhr²,

Sørensen³

et al. 2022

IDR

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There are conflicting data regarding the role of the National Early Warning Score 2 (NEWS2) in predicting adverse outcomes in patients with infectious diseases. New-onset atrial fibrillation (NO-AF) has been suggested as a sepsis-defining sign of organ dysfunction. This study aimed to examine the prognostic accuracy of NEWS2 and whether NO-AF can provide prognostic information in emergency department (ED) patients with suspected bacterial infections. Patients and Methods: Secondary analyses of data from a prospective observational cohort study of adults admitted in a 6-month period with suspected bacterial infections. We used the composite endpoint of in-hospital mortality or transfer to the intensive care unit as the primary outcome. The prognostic accuracy of NEWS2 and quick sequential organ failure assessment (qSOFA) and covariateadjusted area under the receiver operating curves (AAUROC) were used to describe the performance of the scores. Logistic regression analysis was used to examine the association between NO-AF and the composite endpoint. Results: A total of 2055 patients were included in this study. The composite endpoint was achieved in 198 (9.6%) patients. NO-AF was observed in 80 (3.9%) patients. The sensitivity and specificity for NEWS2 ≥5 were 70.2% (63.3-76.5) and 60.2% (57.9-62.4), respectively, and those for qSOFA ≥2 were 26.3% (20.3-33.0) and 91.0% (89.6-92.3), respectively. AAUROC for NEWS2 and qSOFA were 0.68 (0.65-0.73) and 0.63 (0.59-0.68), respectively. The adjusted odds ratio for achieving the composite endpoint in 48 patients with NO-AF who fulfilled the NEWS2 ≥5 criteria was 2.71 (1.35-5.44). Conclusion: NEWS2 had higher sensitivity but lower specificity and better, albeit poor, discriminative ability to predict the composite endpoint compared to qSOFA. NO-AF can provide important prognostic information.

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Section: Discussionmentioning

confidence: 99%

National Early Warning Score and New-Onset Atrial Fibrillation for Predicting In-Hospital Mortality or Transfer to the Intensive Care Unit in Emergency Department Patients with Suspected Bacterial Infections

Nielsen¹,

Stæhr²,

Sørensen³

et al. 2022

IDR

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“…This study is a secondary analysis of the data investigating the utility of triage National Early Warning Score (NEWS) as a predictor of mortality in patients with sepsis. 16 The primary project enrolled all sepsis cases screened in the triaged area. Different levels of NEWS values were examined to identify the best threshold linked to unfavorable clinical outcomes (such as ICU admission, length of stay, and death).…”

Section: Methodsmentioning

confidence: 99%

The impact of emergency antibiotic administration time on patients with sepsis

Althunayyan

Aljanoubi

Alghadeer

et al. 2021

SMJ

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Objectives: To assess the mortality benefits of timely antibiotic treatment of adults present at the emergency department with sepsis and compare one-hour administration and 3-hour administration starting from the time of triage.Methods: In this retrospective study, we used secondary data analysis to investigate the utility of the National Early Warning Score as a predictor of mortality in sepsis patients between

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“…Three studies (21,23,31) used the NEWS2, an updated version of NEWS, and others still used the original NEWS. In addition, 16 studies (20, 21, 24-29, 31-37, 39) estimated the prognostic performance of qSOFA, 10 studies (25-27, 29, 32, 34-37, 39) estimated the prognostic performance of SIRS, and five studies (26,30,34,37,38) also estimated the prognostic performance of NEWS for predicting the ICU admission. Other relevant information is recorded in Supplementary File 4.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

National Early Warning Score Does Not Accurately Predict Mortality for Patients With Infection Outside the Intensive Care Unit: A Systematic Review and Meta-Analysis

Zhang

Ding

et al. 2021

Front. Med.

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Background: The prognostic value of the national early warning score (NEWS) in patients with infections remains controversial. We aimed to evaluate the prognostic accuracy of NEWS for prediction of in-hospital mortality in patients with infections outside the intensive care unit (ICU).Methods: We searched PubMed, Embase, and Scopus for related articles from January 2012 to April 2021. Sensitivity, specificity, and likelihood ratios were pooled by using the bivariate random-effects model. Overall prognostic performance was summarized by using the area under the curve (AUC). We performed subgroup analyses to assess the prognostic accuracy of NEWS in selected populations.Results: A total of 21 studies with 107,008 participants were included. The pooled sensitivity and specificity of NEWS were 0.71 and 0.60. The pooled AUC of NEWS was 0.70, which was similar to quick sequential organ failure assessment (qSOFA, AUC: 0.70) and better than systemic inflammatory response syndrome (SIRS, AUC: 0.60). However, the sensitivity (0.55) and AUC (0.63) of NEWS were poor in elder patients. The NEWS of 5 was more sensitive, which was a better threshold for activating urgent assessment and treatment.Conclusions: The NEWS had good diagnostic accuracy for early prediction of mortality in patients with infections outside the ICU, and the sensitivity and specificity were more moderate when compared with qSOFA and SIRS. Insufficient sensitivity and poor performance in the elder population may have limitations as an early warning score for adverse outcomes. NEWS should be used for continuous monitoring rather than a single time point predictive tool.

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<p>National Early Warning Score (NEWS) as Prognostic Triage Tool for Septic Patients</p>

Cited by 22 publications

References 22 publications

National Early Warning Score and New-Onset Atrial Fibrillation for Predicting In-Hospital Mortality or Transfer to the Intensive Care Unit in Emergency Department Patients with Suspected Bacterial Infections

National Early Warning Score and New-Onset Atrial Fibrillation for Predicting In-Hospital Mortality or Transfer to the Intensive Care Unit in Emergency Department Patients with Suspected Bacterial Infections

The impact of emergency antibiotic administration time on patients with sepsis

National Early Warning Score Does Not Accurately Predict Mortality for Patients With Infection Outside the Intensive Care Unit: A Systematic Review and Meta-Analysis

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