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

AIMS AND OBJECTIVES: To evaluate if the scale used for assessment of hospital ward patients could predict in-hospital and 30-day mortality amongst those with deviating vital signs i.e. 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 signs data.

METHODS: Logistic regression models for age-adjusted in-hospital and 30-day mortality were used for analyses of 1107 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 & 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 & 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 prioritize among patients. This article is protected by copyright. All rights reserved.