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

Abstract

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.

A single-centre cohort study of National Early Warning Score (NEWS) and near patient testing in acute medical admissions

“…We did not identify associations between any combination of NEWS and blood gas variables with hospital length of stay. This supports our other published work, which suggests that NEWS is a poor predictor of hospital length of stay [4], but contrasts with other EWS where a relationship as been noted. [18] This could reflect differences between early warning scores or the populations under investigation.…”

“…We have previously described the study design and data collection in detail [4]. Patients were identified for inclusion from the acute medical take list.…”

“…This captured all patients with cardiac arrest at our institution, since all cardiac arrest survivors are admitted to the critical care unit. This outcome measure has been used previously in similar studies [4][5][6]16]. The secondary outcome measure was hospital length of stay.…”

“…EWS, like NEWS, have the potential to improve risk assessment in acutely unwell patients. NEWS is associated with admission to a critical care unit (level two or three care) and death in studies of patients with cancer, sepsis and medical diagnoses [4][5][6][7][8]. However, there is wider scope for using EWS as tools for prognostication in acutely unwell patients.…”

“…The combination of EWS with near patient testing offers the exciting prospect of 4 improving risk stratification in acute medical patients. Limited evidence suggests that the addition of serum lactate to EWS improved association with clinical outcome, compared to EWS alone [15].…”