A single-centre observational cohort study of admission National Early Warning Score (NEWS)

被引：38

作者：

Abbott, Tom E. F. ^{[1
]}

Vaid, Nidhi ^{[2
]}

Ip, Dorothy ^{[3
]}

Cron, Nicholas ^{[4
]}

Wells, Matt ^{[5
]}

Torrance, Hew D. T. ^{[1
]}

Emmanuel, Julian ^{[1
,6
]}

机构：

[1] Queen Mary Univ London, London EC1M 6BQ, England

[2] Northwick Pk Hosp & Clin Res Ctr, Acute Med, Harrow HA1 1UJ, Middx, England

[3] Whittington Hlth, Acute Med, London N19 5NF, England

[4] London Sch Econ, London WC2A 2AE, England

[5] Cheltenham Gen Hosp, Haematol, Cheltenham GL53 7AN, Glos, England

[6] Barts Hlth NHS Trust, Acute & Metab Med, London E1 1BB, England

来源：

RESUSCITATION | 2015年 / 92卷

关键词：

Early warning score; Monitoring; Clinical outcomes; Physiological parameters; IN-HOSPITAL MORTALITY; OUTCOMES; SYSTEMS; TRACK; RISK;

D O I：

10.1016/j.resuscitation.2015.04.020

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Introduction: Early warning scores are commonly used in hospitals to identify patients at risk of deterioration. The National Early Warning Score (NEWS) has recently been introduced to UK practice. However, it is not yet widely implemented. We aimed to compare NEWS to the early warning score currently used in our hospital - the Patient at Risk Score (PARS). Methods: We conducted a prospective observational cohort study of all adult general medical patients admitted to a single hospital over a 20-day period. Physiological data and early warning scores recorded in bedside charts were collected on admission and a NEWS score was retrospectively calculated. The patient notes were reviewed at 48 h after admission. The primary outcome was a composite of critical care admission or death within 2 days of admission. The secondary outcome was hospital length of stay. Results: NEWS was more strongly associated with the primary outcome than PARS (odds ratio 1.54, p < 0.001 compared to 1.42, p = 0.056). A NEWS of 3 or more was associated with the primary outcome (odds ratio 7.03, p = 0.003). Neither score was correlated with hospital length of stay. Conclusion: NEWS on admission is superior to PARS for identifying patients at risk of death or critical care admission within the first 2 days of hospital stay. Current guidelines advocate a threshold of 5 for triggering a clinical review. However, since a score of 3 or more was associated with a poor outcome, this recommendation should be reviewed. Both scores were poor predictors of hospital length of stay. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

引用

页码：89 / 93

页数：5

共 18 条

[1] The impact of the use of the Early Warning Score (EWS) on patient outcomes: A systematic review [J].