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'National early warning score'

Mikkel Brabrand, Daniel Pilsgaard Henriksen
IMPORTANCE: The CURB-65 score is widely implemented as a prediction tool for identifying patients with community-acquired pneumonia (cap) at increased risk of 30-day mortality. However, since most ingredients of CURB-65 are used as general prediction tools, it is likely that other prediction tools, e.g. the British National Early Warning Score (NEWS), could be as good as CURB-65 at predicting the fate of CAP patients. OBJECTIVE: To determine whether NEWS is better than CURB-65 at predicting 30-day mortality of CAP patients...
March 14, 2018: Lung
Joonas Tirkkonen, Heini Huhtala, Sanna Hoppu
AIM: Study the incidence and reasons behind in-hospital cardiac arrests (IHCAs) after rapid response team (RRT) reviews. METHODS: We conducted a matched case-control study at Tampere University Hospital, Finland. Data on adult patients who were triaged to remain on general ward after first (index) RRT review without treatment limitations but who suffered an IHCA within the following 48 hours were prospectively collected for 5.3 years. These cases were matched (age +/- 3 years, sex, surgical/medical ward, admission year) at a 1:4 ratio to controls (no ICHA after RRT review)...
March 6, 2018: Resuscitation
Alan Glasper
Emeritus Professor Alan Glasper, University of Southampton, discusses the contribution of the Royal College of Physicians to effective monitoring of sick patients in hospital.
March 8, 2018: British Journal of Nursing: BJN
M Brabrand, J Kellett, M Opio, T Cooksley, C H Nickel
INTRODUCTION: Vital signs are routinely used to assess acutely ill patients, but they do not detect all patients at risk of death. This retrospective multicenter cohort study compares the prediction of death by impaired mobility with age, co-morbidities, and vital sign changes. METHODS: On first assessment, patients from a combined cohort of 9684 Danish and Irish patients and a separate cohort of 1010 Ugandan patients were stratified by impaired mobility on presentation (IMOP), vital sign changes assessed by the National Early Warning Score (NEWS), the Charlson Co-morbidity Index, and age...
March 6, 2018: Acta Anaesthesiologica Scandinavica
Tom E F Abbott, Nicholas Cron, Nidhi Vaid, Dorothy Ip, Hew D T Torrance, Julian Emmanuel
Background: National Early Warning Score (NEWS) is increasingly used in UK hospitals. However, there is only limited evidence to support the use of pre-hospital early warning scores. We hypothesised that pre-hospital NEWS was associated with death or critical care escalation within the first 48 h of hospital stay. Methods: Planned secondary analysis of a prospective cohort study at a single UK teaching hospital. Consecutive medical ward admissions over a 20-day period were included in the study...
March 2018: Annals of Medicine and Surgery
Robert Goulden, Marie-Claire Hoyle, Jessie Monis, Darran Railton, Victoria Riley, Paul Martin, Reynaldo Martina, Emmanuel Nsutebu
BACKGROUND: The third international consensus definition for sepsis recommended use of a new prognostic tool, the quick Sequential Organ Failure Assessment (qSOFA), based on its ability to predict inhospital mortality and prolonged intensive care unit (ICU) stay in patients with suspected infection. While several studies have compared the prognostic accuracy of qSOFA to the Systemic Inflammatory Response Syndrome (SIRS) criteria in suspected sepsis, few have compared qSOFA and SIRS to the widely used National Early Warning Score (NEWS)...
February 21, 2018: Emergency Medicine Journal: EMJ
Muhammad Faisal, Andy Scally, Musab Ahmed Elgaali, Donald Richardson, Kevin Beatson, Mohammed A Mohammed
Hospital-acquired acute kidney injury (H-AKI) is a common cause of avoidable morbidity and mortality. Therefore , in the current study, we investigated whether vital signs data from patients, as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. We analysed all emergency admissions (n=33,608) to York Hospital with NEWS data over a 24-month period. Here, we report the area under the curve (AUC) for logistic regression models that used the index NEWS (model A0), plus age and sex (A1), plus subcomponents of NEWS (A2) and two-way interactions (A3), and similarly for maximum NEWS (models B0,B1,B2,B3)...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Bartlomiej Bartkowiak, Ashley M Snyder, Andrew Benjamin, Andrew Schneider, Nicole M Twu, Matthew M Churpek, Kevin K Roggin, Dana P Edelson
OBJECTIVE: Assess the accuracy of 3 early warning scores for predicting severe adverse events in postoperative inpatients. SUMMARY OF BACKGROUND DATA: Postoperative clinical deterioration on inpatient hospital services is associated with increased morbidity, mortality, and cost. Early warning scores have been developed to detect inpatient clinical deterioration and trigger rapid response activation, but knowledge regarding the application of early warning scores to postoperative inpatients is limited...
January 12, 2018: Annals of Surgery
Theresa J Hydes, Paul Meredith, Paul E Schmidt, Gary B Smith, David R Prytherch, Richard J Aspinall
BACKGROUND & AIMS: The National Early Warning Score (NEWS) is used to identify deteriorating adult hospital inpatients. However, it includes physiological parameters frequently altered in patients with cirrhosis. We aimed to assess the performance of the NEWS in acute and chronic liver diseases. METHODS: We collected vital signs, recorded in real time, from completed consecutive admissions of patients 16 years or older to a large acute-care hospital in Southern England, from January 1, 2010 through October 31, 2014...
December 22, 2017: Clinical Gastroenterology and Hepatology
S J Dickson, K A Clay, M Adam, C Ardley, M S Bailey, D S Burns, A T Cox, D G Craig, M Espina, G Fitchett, J Grindrod, D E Hinsley, S Horne, E Hutley, A M Johnston, R L C Kao, L E Lamb, S Lewis, D Marion, A J Moore, T C Nicholson-Roberts, A Phillips, J Praught, P S Rees, I Schoonbaert, T Trinick, D R Wilson, A J Simpson, D Wang, M K O'Shea, T E Fletcher
BACKGROUND: Limited data exist describing supportive care management, laboratory abnormalities and outcomes in patients with EVD (Ebola virus disease) in West Africa. We report data which constitute the first description of the provision of enhanced EVD case management protocols in a West African setting. METHODS: Demographic, clinical and laboratory data were collected by retrospective review of clinical and laboratory records of patients with confirmed EVD admitted between 5 November 2014 and 30 June 2015...
December 14, 2017: Journal of Infection
Leandro Luís, Carla Nunes
INTRODUCTION: Early Warning Score (EWS) systems have been developed for detecting hospital patients clinical deterioration. Many studies show that a National Early Warning Score (NEWS) performs well in discriminating survival from death in acute medical and surgical hospital wards. NEWS is validated for Portugal and is available for use. A simpler EWS system may help to reduce the risk of error, as well as increase clinician compliance with the tool. OBJECTIVES: The aim of the study was to evaluate whether a simplified NEWS model will improve use and data collection...
December 11, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Li Chen, Lipu Deng, Hongmei Zhao, Xiaoying Huang, Xianghua He, Xiangmin Li, Ben Liu, Yongxiang Xie
OBJECTIVE: To analyze the comparation of national early warning score (NEWS), rapid emergency medicine score (REMS) and acute physiology and chronic health evaluation II (APACHE II) score in predicting prognosis of critically ill patients in emergency department (ED). METHODS: A retrospective study was conducted. Critically ill patients, aged > 16 years, hospitalized > 24 hours, and admitted to the ED of Nanhua Hospital Affiliated to South China University from January 2016 to June 2017 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Malcolm Green, Harvey Lander, Ashley Snyder, Paul Hudson, Matthew Churpek, Dana Edelson
INTRODUCTION: Traditionally, paper based observation charts have been used to identify deteriorating patients, with emerging recent electronic medical records allowing electronic algorithms to risk stratify and help direct the response to deterioration. OBJECTIVE(S): We sought to compare the Between the Flags (BTF) calling criteria to the Modified Early Warning Score (MEWS), National Early Warning Score (NEWS) and electronic Cardiac Arrest Risk Triage (eCART) score...
February 2018: Resuscitation
T Szakmany, R Pugh, M Kopczynska, R M Lundin, B Sharif, P Morgan, G Ellis, J Abreu, S Kulikouskaya, K Bashir, L Galloway, H Al-Hassan, T Grother, P McNulty, S T Seal, A Cains, M Vreugdenhil, M Abdimalik, N Dennehey, G Evans, J Whitaker, E Beasant, C Hall, M Lazarou, C V Vanderpump, K Harding, L Duffy, A Guerrier Sadler, R Keeling, C Banks, S W Y Ng, S Y Heng, D Thomas, E W Puw, I Otahal, C Battle, O Minik, R A Lyons, J E Hall
Our aim was to prospectively determine the predictive capabilities of SEPSIS-1 and SEPSIS-3 definitions in the emergency departments and general wards. Patients with National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled over a 24-h period in 13 Welsh hospitals. The primary outcome measure was mortality within 30 days. Out of the 5422 patients screened, 431 fulfilled inclusion criteria and 380 (88%) were recruited. Using the SEPSIS-1 definition, 212 patients had sepsis...
November 17, 2017: Anaesthesia
Daniel A Potter, Nicholas Wroe, Helen Redhead, Andrew Jp Lewington
Introduction: This study investigated outcomes in critically unwell acute kidney injury patients and the role of the National Early Warning Score and other factors in identifying patients who experience negative outcomes. Methods: Retrospective cohort study investigating 64 patients seen by Critical Care Outreach between November 2014 and February 2015. Mortality at one year was analysed using multivariate regression; all other statistical tests were non-parametric...
November 2017: Journal of the Intensive Care Society
Erina Ghosh, Larry Eshelman, Lin Yang, Eric Carlson, Bill Lord
INTRODUCTION: Early detection of deterioration could facilitate more timely interventions which are instrumental in reducing transfer to higher levels of care such as Intensive Care Unit (ICU) and mortality [1,2]. METHODS AND RESULTS: We developed the Early Deterioration Indicator (EDI) which uses log likelihood risk of vital signs to calculate continuous risk scores. EDI was developed using data from 11,864 general ward admissions. To validate EDI, we calculated EDI scores on an additional 2418 general ward stays and compared it to the Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS)...
January 2018: Resuscitation
Paula Mayo
Accurate assessment of the acutely ill adult who has recently been admitted to hospital, or an inpatient whose condition begins to deteriorate, is becoming a required skill for nurses as people live longer and with a variety of complex conditions, and as nursing skills continue to evolve and develop. This article emphasises the importance of undertaking an accurate and comprehensive patient assessment to ensure that management strategies are implemented in a timely manner. The article also considers the importance of the National Early Warning Score (NEWS), which is a 'track-and-trigger' tool designed to identify patients who are at risk of deterioration...
October 18, 2017: Nursing Standard
N E Pedersen, L S Rasmussen, J A Petersen, T A Gerds, D Østergaard, A Lippert
BACKGROUND: The National Early Warning Score (NEWS) uses physiological variables to detect deterioration in hospitalized patients. However, patients with chronic respiratory disease may have abnormal variables not requiring interventions. We studied how the Capital Region of Denmark NEWS Override System (CROS), the Chronic Respiratory Early Warning Score (CREWS) and the Salford NEWS (S-NEWS) affected NEWS total scores and NEWS performance. METHODS: In an observational study, we included patients with chronic respiratory disease...
February 2018: Acta Anaesthesiologica Scandinavica
R S Nannan Panday, T C Minderhoud, N Alam, P W B Nanayakkara
BACKGROUND: A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). METHODS: A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017...
November 2017: European Journal of Internal Medicine
Mikkel Brabrand, Peter Hallas, Søren Nygaard Hansen, Kristian Møller Jensen, Janni Lynggård Bo Madsen, Stefan Posth
INTRODUCTION: "Early warning scores" (EWS) have been developed to quantify levels of vital sign abnormality. However, many scores have not been validated. The aim of this study was to validate six scores that all rely on vital signs: Rapid Acute Physiology Score (RAPS), Rapid Emergency Medicine Score (REMS) and the National Early Warning Score (NEWS) and the Goodacre, Groarke and Worthing physiological scores. METHODS: A posthoc single-center observational cohort study of prospectively collected vital signs on acutely admitted medical patients to a Danish hospital...
November 2017: European Journal of Internal Medicine
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