Evaluation of a Nakornping Early Warning Scores (NEWS) at Emergency Department to predict 24 hours mortality of sepsis patients
Keywords:
NEWS, sepsis, ED triage, mortalityAbstract
Background: Nakornping hospital has been implemented Nakornping Early Warning Scores (NEWS) for screening in sepsis patients. But this tool is not widely used due to lack of confidence to its performances.
Objective: To evaluate prediction potential of NEWS score at emergency department (ED) triage station and 24-hour mortality and in-hospital mortality of sepsis patients and to explore other factors related to the mortality.
Methods: This is a prospective observational study of sepsis patients who visited ED during November 1, 2017 to January 31, 2018. Patients aged ≥ 16 years old and suspected sepsis were included. The patients who were not diagnosed of sepsis, refused treatment or unable to retrieve their data were excluded. The data was analyzed by using multivariable logistic regression to test a relationship between NEWS with other factors and mortality, sensitivity specificity and likelihood ration were used to analyse the performances.
Results: Three hundred and nine patients were enrolled; 21 cases (6.8%) were death in 24 hours and 140 cases (45.3%) were death during the admission. NEWS ≥4 had specificity, sensitivity and LH: 95.24%, 42.01% and 1.64 respectively. NEWS ≥4 was related to 24-hour mortality significantly with Adj. OR 10.02, p-value = 0.031. Other factors that related to the 24-hour mortality were male sex (Adj. OR 5.07, p-value =0.032), and alcoholism or had liver disease (Adj. OR=3.60, p-value =0.018). NEWS≥ 4 was related to in-hospital mortality significantly (Adj. OR = 2.50, p-value = 0.001). Other factors affecting in-hospital mortality were HIV (Adj. OR = 3.59, p-value = 0.033), cancer (Adj. OR = 5.11, p-value = 0.002), referred from local hospital (Adj. OR = 3.87, p-value <0.001).
Conclusion: NEWS ≥ 4 at ED triage can predict 24-hour mortality and in-hospital mortality of sepsis patients significantly.
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