Predicting severe outcomes using national early warning score (NEWS) in patients identified by a rapid response system: a retrospective cohort study

• Published in: Scientific reports Vol. 11; no. 1; pp. 18021 - 8
• Main Authors: Kim, Sang Hyuk, Choi, Hye Suk, Jin, Eun Suk, Choi, Hayoung, Lee, Hyun, Lee, Sang-Hwa, Lee, Chang Youl, Lee, Myung Goo, Kim, Youlim
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09.09.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/409; 692/499; Aged; Aged, 80 and over; Area Under Curve; Body Temperature; Clinical deterioration; Cohort analysis; Critical Illness; Early Warning Score; Female; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - mortality; Gastrointestinal Diseases - pathology; Hospital Mortality; Hospital Rapid Response Team - organization & administration; Humanities and Social Sciences; Humans; Intensive Care Units; Logistic Models; Lung Diseases - diagnosis; Lung Diseases - mortality; Lung Diseases - pathology; Male; Middle Aged; Mortality; multidisciplinary; Neoplasms - diagnosis; Neoplasms - mortality; Neoplasms - pathology; Patients; Republic of Korea; Retrospective Studies; ROC Curve; Science; Science (multidisciplinary); Survival Analysis; Urologic Diseases - diagnosis; Urologic Diseases - mortality; Urologic Diseases - pathology; Vital signs; Republic of Korea
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-97121-w

There are insufficient data in managing patients at high risk of deterioration. We aimed to investigate that national early warning score (NEWS) could predict severe outcomes in patients identified by a rapid response system (RRS), focusing on the patient’s age. We conducted a retrospective cohort study from June 2019 to December 2020. Outcomes were unplanned intensive care unit (ICU) admission, ICU mortality, and in-hospital mortality. We analyzed the predictive ability of NEWS using receiver operating characteristics (ROC) curve and the effect of NEWS parameters using multivariable logistic regression. A total of 2,814 RRS activations were obtained. The predictive ability of NEWS for unplanned ICU admission and in-hospital mortality was fair but was poor for ICU mortality. The predictive ability of NEWS showed no differences between patients aged 80 years or older and under 80 years. However, body temperature affected in-hospital mortality for patients aged 80 years or older, and the inverse effect on unplanned ICU admission was observed. The NEWS showed fair predictive ability for unplanned ICU admission and in-hospital mortality among patients identified by the RRS. The different presentations of patients 80 years or older should be considered in implementing the RRS.