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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

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@article{d81f7326cef44be7b7da8a2c97f8848b,
title = "The National Early Warning Score predicts mortality in hospital ward patients with deviating vital signs: A retrospective medical record review study",
abstract = "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.",
keywords = "Early Warning Score, Medical Emergency Team, National Early Warning Score, critical care, critical care outreach, hospital mortality, in-hospital cardiac arrest, vital signs, Prospective Studies, Hospital Mortality, Risk Assessment, Humans, Middle Aged, Decision Support Techniques, Logistic Models, Male, Critical Illness/classification, Clinical Deterioration, Vital Signs/physiology, Adult, Female, Aged, Retrospective Studies",
author = "Martin Sp{\aa}ngfors and Gitte Bunkenborg and Mats Molt and Karin Samuelson",
note = "{\circledC} 2018 John Wiley & Sons Ltd.",
year = "2019",
month = "4",
doi = "10.1111/jocn.14728",
language = "English",
volume = "28",
pages = "1216--1222",
journal = "Journal of Clinical Nursing",
issn = "0962-1067",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "7-8",

}

RIS

TY - JOUR

T1 - The National Early Warning Score predicts mortality in hospital ward patients with deviating vital signs

T2 - A retrospective medical record review study

AU - Spångfors, Martin

AU - Bunkenborg, Gitte

AU - Molt, Mats

AU - Samuelson, Karin

N1 - © 2018 John Wiley & Sons Ltd.

PY - 2019/4

Y1 - 2019/4

N2 - 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.

AB - 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.

KW - Early Warning Score

KW - Medical Emergency Team

KW - National Early Warning Score

KW - critical care

KW - critical care outreach

KW - hospital mortality

KW - in-hospital cardiac arrest

KW - vital signs

KW - Prospective Studies

KW - Hospital Mortality

KW - Risk Assessment

KW - Humans

KW - Middle Aged

KW - Decision Support Techniques

KW - Logistic Models

KW - Male

KW - Critical Illness/classification

KW - Clinical Deterioration

KW - Vital Signs/physiology

KW - Adult

KW - Female

KW - Aged

KW - Retrospective Studies

UR - http://www.scopus.com/inward/record.url?scp=85059637434&partnerID=8YFLogxK

U2 - 10.1111/jocn.14728

DO - 10.1111/jocn.14728

M3 - Journal article

VL - 28

SP - 1216

EP - 1222

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

SN - 0962-1067

IS - 7-8

ER -

ID: 55767138