Purpose
We assessed the National Early Warning Score (NEWS) in emergency triage for predicting sepsis-related outcomes.
Methods
A retrospective chart review of all cases enrolled in the sepsis management protocol for a one-year duration. The protocol utilized the NEWS as a screening tool for sepsis in the triage area. Primary outcomes of interest were hyperlactatemia, admission to ICU and intrahospital mortality. Sensitivity, specificity, and area under the curve (AUC) were calculated for a given NEWS.
Results
A total of 444 patients were reviewed from July 2018 to June 2019, with a mean age of 58.7 years. A NEWS ≥5 was more than 88% sensitive in predicting hyperlactatemia, ICU admission, and/or mortality. Specificity, on the other hand, was as low as 12%. The AUC for the NEWS was 0.667 for predicting hyperlactatemia and 0.602 for predicting ICU admission or mortality.
Conclusion
The NEWS was a sensitive screening tool for predicting sepsis-related outcomes. However, it was not specific, and further studies are recommended to assess the integration of other factors to improve specificity.
Clinical localisation of CTM by emergency medicine trainees was poor even in non-stressful settings, and warrants further dedicated education and/or use of adjunct techniques.
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