Infection and Drug Resistance (Oct 2020)

National Early Warning Score (NEWS) as Prognostic Triage Tool for Septic Patients

  • Almutary A,
  • Althunayyan S,
  • Alenazi K,
  • Alqahtani A,
  • Alotaibi B,
  • Ahmed M,
  • Osman IS,
  • Kakpuri A,
  • Alanazi A,
  • Arafat M,
  • Al-Mutairi A,
  • Bashraheel F,
  • Almazroua F

Journal volume & issue
Vol. Volume 13
pp. 3843 – 3851

Abstract

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Abdulaziz Almutary,1 Saqer Althunayyan,2 Khaled Alenazi,3 Abdulrahman Alqahtani,4 Badar Alotaibi,5 Marwa Ahmed,6 Isam S Osman,7 Adil Kakpuri,8 Abdulaziz Alanazi,9 Mohammed Arafat,10 Abdulmajeed Al-Mutairi,11 Fatma Bashraheel,12 Faisal Almazroua1 1Emergency Department, King Saud Medical City, Riyadh, Saudi Arabia; 2Department of Accident and Trauma, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia; 3Internal Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia; 4Vision Realization Office, Ministry of Health, Riyadh, Saudi Arabia; 5Emergency Department, Riyadh Care Hospital, Riyadh, Saudi Arabia; 6Pharmaceutical Care Services Department, King Saud Medical City, Riyadh, Saudi Arabia; 7Vascular Surgery Department, King Saud Medical City, Riyadh, Saudi Arabia; 8Quality Management and Patient Safety Administration, King Saud Medical City, Riyadh, Saudia Arabia; 9Nursing Administration, King Saud Medical City, Riyadh, Saudia Arabia; 10Emergency Medicine Department, King Saud University Medical City, Riyadh, Saudi Arabia; 11College of Medicine, King Saud University, Riyadh, Saudia Arabia; 12College of Medicine, Alma’arefa University, Riyadh, Saudi ArabiaCorrespondence: Saqer AlthunayyanDepartment of Accident and Trauma, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi ArabiaEmail [email protected]: We assessed the National Early Warning Score (NEWS) in emergency triage for predicting sepsis-related outcomes.Methods: A retrospective chart review of all cases enrolled in the sepsis management protocol for a one-year duration. The protocol utilized the NEWS as a screening tool for sepsis in the triage area. Primary outcomes of interest were hyperlactatemia, admission to ICU and intrahospital mortality. Sensitivity, specificity, and area under the curve (AUC) were calculated for a given NEWS.Results: A total of 444 patients were reviewed from July 2018 to June 2019, with a mean age of 58.7 years. A NEWS ≥ 5 was more than 88% sensitive in predicting hyperlactatemia, ICU admission, and/or mortality. Specificity, on the other hand, was as low as 12%. The AUC for the NEWS was 0.667 for predicting hyperlactatemia and 0.602 for predicting ICU admission or mortality.Conclusion: The NEWS was a sensitive screening tool for predicting sepsis-related outcomes. However, it was not specific, and further studies are recommended to assess the integration of other factors to improve specificity.Keywords: sepsis, lactate, predictor, mortality, septic shock

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