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National Early Warning Score

Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Delay in recognizing clinical deterioration in acutely unwell patients often leads to cardiac arrests and unexpected admissions to the Intensive Care Unit. Early Warning Scoring Systems based on vital physiological parameters help in early detection of clinical deterioration. When combined with a system of prompt and appropriate clinical response, they have been shown to improve outcome. A standardised National Early Warning Score has been implemented in the United Kingdom. There is a need to implement an early warning scoring system in hospitals in India in order to ensure effective and judicious utilization of our overburdened acute services and to minimize adverse outcomes...
May 2016: Journal of the Association of Physicians of India
Diana Sbiti-Rohr, Alexander Kutz, Mirjam Christ-Crain, Robert Thomann, Werner Zimmerli, Claus Hoess, Christoph Henzen, Beat Mueller, Philipp Schuetz
OBJECTIVE: To investigate the accuracy of the National Early Warning Score (NEWS) to predict mortality and adverse clinical outcomes for patients with community-acquired pneumonia (CAP) compared to standard risk scores such as the pneumonia severity index (PSI) and CURB-65. DESIGN: Secondary analysis of patients included in a previous randomised-controlled trial with a median follow-up of 6.1 years. SETTINGS: Patients with CAP included on admission to the emergency departments (ED) of 6 tertiary care hospitals in Switzerland...
2016: BMJ Open
Matthew M Churpek, Ashley Snyder, Xuan Han, Sarah Sokol, Natasha Pettit, Michael D Howell, Dana P Edelson
RATIONALE: The 2016 definitions of sepsis included the quick Sepsis-related Organ Failure Assessment (qSOFA) score to identify high-risk patients outside the intensive care unit (ICU). OBJECTIVE: We sought to compare qSOFA to other commonly used early warning scores. METHODS: All admitted patients first meeting criteria for suspicion of infection in the emergency department (ED) or hospital wards from November 2008 until January 2016 were included...
September 20, 2016: American Journal of Respiratory and Critical Care Medicine
Roman Romero-Ortuno, Stephen Wallis, Richard Biram, Victoria Keevil
AIM: Frail individuals may be at higher risk of death from a given acute illness severity (AIS), but this relationship has not been studied in an English National Health Service (NHS) acute hospital setting. METHODS: This was a retrospective observational study in a large university NHS hospital in England. We analyzed all first non-elective inpatient episodes of people aged ≥75years (all specialties) between October 2014 and October 2015. Pre-admission frailty was assessed with the Clinical Frailty Scale (CFS) of the Canadian Study on Health & Aging, and AIS in the Emergency Department was measured with a Modified Early Warning Score (ED-MEWS<4 was considered as low acuity, and ED-MEWS≥4 as high acuity)...
September 2, 2016: European Journal of Internal Medicine
Luke E Hodgson, Borislav D Dimitrov, Jo Congleton, Richard Venn, Lui G Forni, Paul J Roderick
BACKGROUND: The National Early Warning Score (NEWS), proposed as a standardised track and trigger system, may perform less well in acute exacerbation of COPD (AECOPD). This study externally validated NEWS and modifications (Chronic Respiratory Early Warning Score (CREWS) and Salford-NEWS) in AECOPD. METHODS: An observational cohort study (2012-2014, two UK acute medical units (AMUs)), compared AECOPD (2361 admissions, 942 individuals, International Statistical Classification of Diseases and Related Health Problems-10 J40-J44 codes) with AMU patients (37 109 admissions, 20 415 individuals)...
August 23, 2016: Thorax
Sion Jo, Jaechol Yoon, Jae Baek Lee, Youngho Jin, Taeoh Jeong, Boyoung Park
STUDY OBJECTIVES: What is the predictive value of the National Early Warning Score-Lactate (NEWS-L) score for mortality and the need for critical care in general emergency department (ED) patients? METHODS: In this retrospective cohort study, we enrolled all adult patients who visited the ED of an urban academic tertiary-care university hospital in South Korea over 2 consecutive months. The primary outcome was 2-day mortality. The secondary outcomes were the need for critical care (advanced airway use, vasopressor or inotropic agent use, intensive care unit admission) during an ED stay; 2-day composite outcome (2-day mortality and the need for critical care); 7-day mortality; and in-hospital mortality...
June 29, 2016: Journal of Critical Care
Gary B Smith, David R Prytherch, Stuart Jarvis, Caroline Kovacs, Paul Meredith, Paul E Schmidt, Jim Briggs
OBJECTIVE: To compare the ability of medical emergency team criteria and the National Early Warning Score to discriminate cardiac arrest, unanticipated ICU admission and death within 24 hours of a vital signs measurement, and to quantify the associated workload. DESIGN: Retrospective cohort study. SETTING: A large U.K. National Health Service District General Hospital. PATIENTS: Adults hospitalized from May 25, 2011, to December 31, 2013...
August 2, 2016: Critical Care Medicine
C Kovacs, S W Jarvis, D R Prytherch, P Meredith, P E Schmidt, J S Briggs, G B Smith
BACKGROUND: The National Early Warning Score (NEWS) is used to identify deteriorating patients in hospital. NEWS is a better discriminator of outcomes than other early warning scores in acute medical admissions, but it has not been evaluated in a surgical population. The study aims were to evaluate the ability of NEWS to discriminate cardiac arrest, death and unanticipated ICU admission in patients admitted to surgical specialties, and to compare the performance of NEWS in admissions to medical and surgical specialties...
September 2016: British Journal of Surgery
Jonathan Bannard-Smith, Geoffrey K Lighthall, Christian P Subbe, Lesley Durham, John Welch, Rinaldo Bellomo, Daryl A Jones
AIM: The study was developed to characterize short-term outcomes of deteriorating ward patients triggering a Rapid Response Team (RRT), and describe variability between hospitals or groups thereof. METHODS: We performed an international prospective study of Rapid Response Team (RRT) activity over a 7-day period in February 2014. Investigators at 51 acute hospitals across Australia, Denmark, the Netherlands, USA and United Kingdom collected data on all patients triggering RRT review concerning the nature, trigger and immediate outcome of RRT review...
October 2016: Resuscitation
Mohammed A Mohammed, Muhammad Faisal, Donald Richardson, Robin Howes, Kevin Beaston, Kevin Speed, John Wright
BACKGROUND: Patients admitted to hospitals over the weekend appear to have a higher risk of death compared to weekday admissions, but the reasons remain unclear. Unlike previous studies, we use a standardised mandated vital signs physiological based measure of sickness known as the National Early Warning Score (NEWS) to investigate this "weekend effect" for emergency admissions. AIM: To determine if weekend admissions are (1) sicker as measured by their index NEWS, (2) have an increased risk of death and (3) have less favourable monitoring of their vital signs compared with weekday admissions...
July 12, 2016: QJM: Monthly Journal of the Association of Physicians
Martin Spångfors, Lisa Arvidsson, Victoria Karlsson, Karin Samuelson
The National Early Warning Score - NEWS is a "track and trigger" scale designed to assess in-hospital patients' vital signs and detect clinical deterioration. In this study the NEWS was translated into Swedish and its association with the need of intensive care was investigated. A total of 868 patient charts, recorded by the medical emergency team at a university hospital, containing the parameters needed to calculate the NEWS were audited. The NEWS was translated into Swedish and tested for inter-rater reliability with a perfect agreement (weighted κ=1...
July 4, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Tom E F Abbott, Hew D T Torrance, Nicholas Cron, Nidhi Vaid, Julian Emmanuel
INTRODUCTION: The utility of an early warning score may be improved when used with near patient testing. However, this has not yet been investigated for National Early Warning Score (NEWS). We hypothesised that the combination of NEWS and blood gas variables (lactate, glucose or base-excess) was more strongly associated with clinical outcome compared to NEWS alone. METHODS: This was a prospective cohort study of adult medical admissions to a single-centre over 20days...
June 23, 2016: European Journal of Internal Medicine
Christian H Nickel, John Kellett, Tim Cooksley, Roland Bingisser, Daniel P Henriksen, Mikkel Brabrand
AIM: To investigate the combined use of NEWS and D-dimer levels to predict the 30-day and 365-day mortality rates of a cohort of Danish patients with complete follow-up. METHODS: Post-hoc retrospective observational study of acutely admitted medical patients aged 18 years or older who had D-dimer measured within 6h after arrival to two medical admission units in Denmark. RESULTS: The final study population consisted of 1201 patients with a median age of 65...
September 2016: Resuscitation
(no author information available yet)
This article examines the evidence base for the introduction of a national early warning scoring (EWS) system for children that is 'effective, audited and quality assured'.
July 1, 2011: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Bente Bilben, Linda Grandal, Signe Søvik
BACKGROUND: National Early Warning Score (NEWS) was designed to detect deteriorating patients in hospital wards, specifically those at increased risk of ICU admission, cardiac arrest, or death within 24 h. NEWS is not validated for use in Emergency Departments (ED), but emerging data suggest it may be useful. A criticism of NEWS is that patients with chronic poor oxygenation, e.g. severe chronic obstructive pulmonary disease (COPD), will have elevated NEWS also in the absence of acute deterioration, possibly reducing the predictive power of NEWS in this subgroup...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Mahableshwar Albur, Fergus Hamilton, Alasdair P MacGowan
BACKGROUND: Early Warning Score (EWS) is a physiological composite score of six bedside vital parameters, routinely used in UK hospitals. We evaluated the prognostic ability of EWS in Gram-negative bacteraemia causing sepsis. METHODS: We prospectively evaluated EWS as a marker of severity and prognosis in adult patients with Gram-negative bacteraemia. All adult patients with Gram-negative bacteraemia admitted to our tertiary Teaching hospital of the National Health Service in England were enrolled over 1 year period...
2016: Annals of Clinical Microbiology and Antimicrobials
Audrey Catherine Quinn, Tim Meek, Carl Waldmann
PURPOSE OF REVIEW: Early warning scores, early warning systems and rapid response systems, were established in 1999. In the UK, a National Early Warning Score was launched in 2013 and is now used throughout the National Health Service. In 2007, a firm recommendation was made by the maternal confidential death enquiry that maternity units should incorporate a modified early obstetric warning score chart into clinical practice. Although there was enthusiastic uptake of this recommendation, local recording systems vary throughout the country and there is now a need to revisit revise and standardize an obstetric early warning system (ObsEWS)...
June 2016: Current Opinion in Anaesthesiology
Rebecca Kruisselbrink, Arthur Kwizera, Mark Crowther, Alison Fox-Robichaud, Timothy O'Shea, Jane Nakibuuka, Isaac Ssinabulya, Joan Nalyazi, Ashley Bonner, Tahira Devji, Jeffrey Wong, Deborah Cook
INTRODUCTION: Providing optimal critical care in developing countries is limited by lack of recognition of critical illness and lack of essential resources. The Modified Early Warning Score (MEWS), based on physiological parameters, is validated in adult medical and surgical patients as a predictor of mortality. The objective of this study performed in Uganda was to determine the prevalence of critical illness on the wards as defined by the MEWS, to evaluate the MEWS as a predictor of death, and to describe additional risk factors for mortality...
2016: PloS One
Michael Christ, Roland Bingisser, Christian Hans Nickel
In emergency departments, patients present with different severities of diseases and traumatic injuries. However, patients with severe and life-threatening conditions compete for the same resources such as personal and structure. As a general rule, each patient should receive immediate diagnostic and treatment, independent of his or her severity of disease or traumatic injury. However, an unexpected number of patients presenting to the emergency department at the same time may exceed available resources. Thus, waiting times will occur and management of patients may be impeded...
March 2016: Deutsche Medizinische Wochenschrift
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