Vital Signs or Lab parameters: Evaluation of National Early Warning Score2 (NEWS2) and Sequential Organ Failure Assessment (SOFA) Scores for Sepsis Screening in Low resource Hospital Setting

Abstract

BACKGROUND: Diagnosing sepsis is challenging due to its complex onset. Despite various scoring systems, diagnostic inconsistencies persist. The Surviving Sepsis Campaign (SSC) 2021 recommends the SOFA score, but it relies on lab tests often unavailable in low-resource settings. Conversely, the NEWS2 score, based on vital signs alone, presents a practical alternative. AIM: To compare the diagnostic accuracy of NEWS2 and SOFA scores in predicting sepsis in Low resource Hospitals. METHODS: This 6-month Prospective Observational study conducted in a South Indian tertiary care hospital's Emergency Department (ED) and ICUs from. Patients with signs of infection were screened for sepsis as per SSC 2021 guidelines are included. NEWS2 and SOFA scores were used to screen sepsis on admission day. Lab parameters and Vitals are collected, analyzed using SPSS for sensitivity, specificity and Area Under Receiver Operating Curve (AUROC). RESULTS: Of 568 patients with signs of infection scores were applied, 131 (23.06%) were diagnosed with sepsis and 32 (24.4%) died. NEWS2 had higher AUROC of 0.78, compared to SOFA's AUROC of 0.61. (Table 1). For predicting mortality, both scores were significant, NEWS2 ≥5 had a higher AUROC. Results in (Table 2), ROC curves in Figures 1 and 2. CONCLUSION: The NEWS2 score showed superior performance over SOFA in predicting sepsis, with higher AUROC, sensitivity, and specificity. This highlights NEWS2 as a significant tool for early sepsis detection and management in low resource hospital settings as it relies only on vital sign. Further large studies should validate its effectiveness against other early warning scores.

Keywords

• Sepsis
• SOFA score
• NEWS2 score
• Low resource settings