The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death
The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death
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DOI：
10.1016/j.resuscitation.2012.12.016
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发表时间：
2013-04-01
期刊：
影响因子：
6.5
通讯作者：
Featherstone, Peter I.
中科院分区：
文献类型：
--
作者：
Smith, Gary B.;Prytherch, David R.;Featherstone, Peter I.
早期预警评分（EWS）被推荐作为早期识别和应对患者恶化的一部分。英国皇家内科医师学院建议使用国家早期预警评分（NEWS）作为所有成年患者的常规临床评估。方法：我们测试了NEWS在NEWS值24小时内区分心脏骤停、非预期重症监护病房（ICU）入住或死亡风险患者的能力，并将其与目前使用的33个其他ews的性能进行了比较，使用接受者操作特征（AUROC）曲线下面积和大型生命体征数据库（n = 198,755个观察集），这些数据来自35,585个连续完成的急性医疗入院患者。结果：24小时内发生心脏骤停、意外入院、死亡及其他任何结局的auroc （95% CI）分别为0.722（0.685-0.759）、0.857（0.847-0.868）、0.894（0.887-0.902）和0.873（0.866-0.879）。同样，其他33例EWSs的auroc （95% CI）范围为0.611（0.568-0.654）至0.710(0.675-0.745)（心脏骤停）；0.570 (0.553-0.568) ~ 0.827 (0.814-0.840)；0.813(0.802-0.824) ~ 0.858(0.849-0.867)（死亡率）；0.736（0.727-0.745）至0.834(0.826-0.842)（任何结果）。结论：NEWS比其他33个ews有更强的能力区分心脏骤停、意外入住ICU或24小时内死亡风险患者。2013爱思唯尔爱尔兰有限公司版权所有。
Introduction: Early warning scores (EWS) are recommended as part of the early recognition and response to patient deterioration. The Royal College of Physicians recommends the use of a National Early Warning Score (NEWS) for the routine clinical assessment of all adult patients.Methods: We tested the ability of NEWS to discriminate patients at risk of cardiac arrest, unanticipated intensive care unit (ICU) admission or death within 24 h of a NEWS value and compared its performance to that of 33 other EWSs currently in use, using the area under the receiver-operating characteristic (AUROC) curve and a large vital signs database (n = 198,755 observation sets) collected from 35,585 consecutive, completed acute medical admissions.Results: The AUROCs (95% CI) for NEWS for cardiac arrest, unanticipated ICU admission, death, and any of the outcomes, all within 24 h, were 0.722 (0.685-0.759), 0.857 (0.847-0.868), 0.894 (0.887-0.902), and 0.873 (0.866-0.879), respectively. Similarly, the ranges of AUROCs (95% CI) for the other 33 EWSs were 0.611 (0.568-0.654) to 0.710 (0.675-0.745) (cardiac arrest); 0.570 (0.553-0.568) to 0.827 (0.814-0.840) (unanticipated ICU admission); 0.813 (0.802-0.824) to 0.858 (0.849-0.867) (death); and 0.736 (0.727-0.745) to 0.834 (0.826-0.842) (any outcome).Conclusions: NEWS has a greater ability to discriminate patients at risk of the combined outcome of cardiac arrest, unanticipated ICU admission or death within 24 h of a NEWS value than 33 other EWSs. (C) 2013 Elsevier Ireland Ltd. All rights reserved.