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The National Early Warning Score predicts mortality in hospital ward patients with deviating vital signs : A retrospective medical record review study

Spångfors, Martin LU ; Bunkenborg, Gitte LU ; Molt, Mats LU and Samuelson, Karin LU (2019) In Journal of Clinical Nursing 28(7-8). p.1216-1222
Abstract

Aims and objectives: To evaluate whether the scale used for assessment of hospital ward patients could predict in-hospital and 30-day mortality amongst those with deviating vital signs; that is, that patients classified as medium or high risk would have increased risk of in-hospital and 30-day mortality compared to patients with low risk. Background: The National Early Warning Score (NEWS) is a widely adopted scale for assessing deviating vital signs. A clinical risk scale that comes with the NEWS divides the risk for critical illness into three risk categories, low, medium and high. Design: Retrospective analysis of vital sign data. Methods: Logistic regression models for age-adjusted in-hospital and 30-day mortality were used for... (More)

Aims and objectives: To evaluate whether the scale used for assessment of hospital ward patients could predict in-hospital and 30-day mortality amongst those with deviating vital signs; that is, that patients classified as medium or high risk would have increased risk of in-hospital and 30-day mortality compared to patients with low risk. Background: The National Early Warning Score (NEWS) is a widely adopted scale for assessing deviating vital signs. A clinical risk scale that comes with the NEWS divides the risk for critical illness into three risk categories, low, medium and high. Design: Retrospective analysis of vital sign data. Methods: Logistic regression models for age-adjusted in-hospital and 30-day mortality were used for analyses of 1,107 patients with deviating vital signs. Results: Patients classified as medium or high risk by NEWS experienced a 2.11 or 3.40 increase, respectively, in odds of in-hospital death (95% CI: 1.27–3.51, p = 0.004% and 95% CI: 1.90–6.01, p < 0.001) compared to low-risk patients. Moreover, those with NEWS medium or high risk were associated with a 1.98 or 3.19 increase, respectively, in odds of 30-day mortality (95% CI: 1.32–2.97, p = 0.001% and 95% CI: 1.97–5.18, p < 0.001). Conclusion: The NEWS risk classification seems to be a reliable predictor of mortality on patients in hospital wards. Relevance to clinical practice: The NEWS risk classification offers a simple way to identify deteriorating patients and can aid the healthcare staff to prioritise amongst patients.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
critical care, critical care outreach, Early Warning Score, hospital mortality, in-hospital cardiac arrest, Medical Emergency Team, National Early Warning Score, vital signs
in
Journal of Clinical Nursing
volume
28
issue
7-8
pages
1216 - 1222
publisher
Wiley-Blackwell
external identifiers
  • pmid:30516860
  • scopus:85059637434
ISSN
0962-1067
DOI
10.1111/jocn.14728
language
English
LU publication?
yes
id
de8fbbe5-2af6-4fd8-adc7-960d0e6e127f
date added to LUP
2019-01-18 14:08:44
date last changed
2020-07-08 04:39:16
@article{de8fbbe5-2af6-4fd8-adc7-960d0e6e127f,
  abstract     = {<p>Aims and objectives: To evaluate whether the scale used for assessment of hospital ward patients could predict in-hospital and 30-day mortality amongst those with deviating vital signs; that is, that patients classified as medium or high risk would have increased risk of in-hospital and 30-day mortality compared to patients with low risk. Background: The National Early Warning Score (NEWS) is a widely adopted scale for assessing deviating vital signs. A clinical risk scale that comes with the NEWS divides the risk for critical illness into three risk categories, low, medium and high. Design: Retrospective analysis of vital sign data. Methods: Logistic regression models for age-adjusted in-hospital and 30-day mortality were used for analyses of 1,107 patients with deviating vital signs. Results: Patients classified as medium or high risk by NEWS experienced a 2.11 or 3.40 increase, respectively, in odds of in-hospital death (95% CI: 1.27–3.51, p = 0.004% and 95% CI: 1.90–6.01, p &lt; 0.001) compared to low-risk patients. Moreover, those with NEWS medium or high risk were associated with a 1.98 or 3.19 increase, respectively, in odds of 30-day mortality (95% CI: 1.32–2.97, p = 0.001% and 95% CI: 1.97–5.18, p &lt; 0.001). Conclusion: The NEWS risk classification seems to be a reliable predictor of mortality on patients in hospital wards. Relevance to clinical practice: The NEWS risk classification offers a simple way to identify deteriorating patients and can aid the healthcare staff to prioritise amongst patients.</p>},
  author       = {Spångfors, Martin and Bunkenborg, Gitte and Molt, Mats and Samuelson, Karin},
  issn         = {0962-1067},
  language     = {eng},
  number       = {7-8},
  pages        = {1216--1222},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Clinical Nursing},
  title        = {The National Early Warning Score predicts mortality in hospital ward patients with deviating vital signs : A retrospective medical record review study},
  url          = {http://dx.doi.org/10.1111/jocn.14728},
  doi          = {10.1111/jocn.14728},
  volume       = {28},
  year         = {2019},
}