Prehospital National Early Warning Score predicts early mortality

Area of Science:

• Emergency Medicine
• Public Health
• Clinical Epidemiology

Background:

• The National Early Warning Score (NEWS) is established for predicting in-hospital mortality.
• Limited data exists on NEWS' predictive capability in the prehospital environment.
• This study addresses the gap in understanding NEWS' prehospital utility.

Purpose of the Study:

• To evaluate the diagnostic accuracy of prehospital National Early Warning Score (NEWS) for predicting short-term mortality.
• To assess the NEWS score's predictive value in a large, population-based prehospital setting.

Main Methods:

• Retrospective analysis of prehospital electronic patient records from the Hospital District of Helsinki and Uusimaa, Finland.
• Inclusion of patients aged 18 years or older with sufficient data for NEWS calculation between August 2008 and December 2015.
• Primary outcome defined as death within 1 day of emergency medical services (EMS) dispatch.

Main Results:

• 35,800 patients were analyzed, with a mean age of 65.8 years.
• The median NEWS score was 3, and 1-day mortality occurred in 1.1% of cases.
• The Area Under the Receiver Operating Characteristic Curve (AUROC) for 1-day mortality was 0.840 (95% CI 0.823-0.858), with a higher AUROC of 0.901 in the trauma subgroup.

Conclusions:

• Prehospital National Early Warning Score (NEWS) demonstrates good diagnostic accuracy for predicting mortality within 1 day of EMS dispatch.
• NEWS is a valuable tool for risk stratification in the prehospital setting.
• The findings support the use of NEWS in prehospital care to identify high-risk patients.