Association between Prehospital National Early Warning Score (NEWS) And the older Patients’Mortality Rate

Authors

  • Thanaporn Hemwej Emergency department, Banpong hospital

Keywords:

older patients, emergency medical service, NEWS, mortality

Abstract

Introduction
National Early Warning Score (NEWS) is one of the recognized tools for the early identification of clinical deterioration using seven basic physiological findings. The use of the new score is primarily for adults within hospital settings. However, studies evaluating the NEWS in prehospital settings for older patients are limited.

Objectives
To determine the association of NEWS and 30-day mortality among older patients in the prehospital settings.

Method
A retrospective cohort study enrolled older patients age ≥65 years who visited the emergency department (ED) by emergency medical service (EMS) from 1 November 2021 to 1 February 2023. The data were collected from electronic medical record and medical record at the scene. The association between NEWS and 30-day mortality was assessed.

Results
Five hundred and seven patients were enrolled in this study. The 30-day mortality was 19.7%. Area under receiving operating characteristic curve (AUROC) was 0.726. NEWS ≥8 predicted mortality with sensitivity 73% (95%CI, 64-81) and specificity 63.6% (95%CI, 58.7-68.1).

Conclusion
Pre-hospital NEWS was associated with 30-day mortality in older patients. Therefore, pre-hospital NEWS may be useful to recognize early signs of clinical deteriorate in older patients and may be applied in emergency medical service in order to provide prompt an appropriate treatment to these patients.

References

วีรศักดิ์ เมืองไพศาล. (2557). ภาวะฉุกเฉินในผู้สูงอายุ. ใน วีรศักดิ์ เมืองไพศาล (บรรณาธิการ), การจำกัดการภาวะฉุกเฉินสำหรับผู้สูงอายุ (หน้า 1-4). กรุงเทพมหานคร: ห้างหุ้นส่วนจำกัด ภาพพิมพ์.

Rutschmann OT, Chevalley T, Zumwald C, Luthy C, Vermeulen B, Sarasin FP. Pitfalls in the emergency department triage of frail elderly patients without specific complaints. Swiss Med Wkly 2005;135:145-50.

American College of Emergency Physicians. Crowding. Available at: https://www.acep.org/patient-care/policy-statements/crowding/. Retrieved March 25, 2022.

Jones M. NEWSDIG: the National early warning score development and implementation group. Clin Med 2012; 12:501–3.

Physicians TRCo. National early warning score (news) standardizing the assessment of acute-illness severity in the NHS, 2012.

Vardy E, Lasserson D, Barker R, Hanratty B. NEWS2 and the older person. Clin Med 2022; 22(6):522–4. 7. Chester JG, Rudolph JL. Vital signs in older patients: age related changes. J Am Med Dir Assoc 2011;12:337–43.

Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardizing the assessment of acute-illness severity in the NHS. RCP, 20179. Silcock DJ, Corfield AR, Gowens PA, Rooney KD. Validation of the National Early Warning score in the prehospital setting. Resuscitation. 2015;89:31–5. doi:10.1016/j.resuscitation.2014.12.029.

Endo T, Yoshida T, Shinozaki T, Motohashi T, Hsu H-C, Fukuda S, et al. Efficacy of prehospital national early warning score to predict outpatient disposition at an emergency department of a Japanese Tertiary Hospital: A retrospective study. BMJ Open. 2020;10(6). doi:10.1136/bmjopen-2019-034602

Semeraro F, Corona G, Scquizzato T, Gamberini L, Valentini A, Tartaglione M, et al. New early warning score: Ems off-label use in out-of-hospital patients. Journal of Clinical Medicine. 2021;10(12):2617. doi:10.3390/jcm10122617

Abbott TEF, Cron N, Vaid N, Ip D, Torrance HDT, Emmanuel J. Pre-hospital national early warning score (news) is associated with in-hospital mortality and Critical Care Unit Admission: A cohort study. Annals of Medicine and Surgery. 2018;27:17–21. doi:10.1016/j.amsu.2018.01.006

Hoikka M, Silfvast T, Ala-Kokko TI. Does the Prehospital National Early Warning score predict the short-term mortality of unselected emergency patients? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2018;26(1). doi:10.1186/s13049-018-0514-1

Saberian P, Abdollahi A, Hasani-Sharamin P, Modaber M, Karimialavijeh E. Comparing the prehospital news with in-hospital ESI in predicting 30-day severe outcomes in emergency patients. BMC Emergency Medicine. 2022;22(1). doi:10.1186/s12873-022-00598-5

Winthachai O, Hengrussamee C. Agreement of Prehospital Severity Assignment: Comparisons among 3 Different Patient Assessment Tools in Urban Emergency Medical Service. Vajira Med J [Internet]. 2020 Jun. 30 [cited 2023 Jul. 27];64(3):193-204. Available from: https://he02.tci-thaijo.org/index.php/VMED/article/view/221575

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Published

2023-12-14

How to Cite

1.
Hemwej T. Association between Prehospital National Early Warning Score (NEWS) And the older Patients’Mortality Rate. TJEM [Internet]. 2023 Dec. 14 [cited 2024 Dec. 22];5(1):18-32. Available from: https://he02.tci-thaijo.org/index.php/TJEM/article/view/262951