National Early Warning Score (NEWS) as Prognostic Triage Tool for Septic Patients

Area of Science:

• Emergency Medicine
• Critical Care Medicine
• Clinical Scoring Systems

Background:

• Sepsis remains a significant cause of mortality and morbidity worldwide.
• Early identification of sepsis in emergency departments is crucial for timely intervention and improved patient outcomes.
• The National Early Warning Score (NEWS) is a widely used tool for assessing acute illness severity.

Purpose of the Study:

• To evaluate the effectiveness of the National Early Warning Score (NEWS) as a screening tool for sepsis in emergency triage.
• To assess the predictive accuracy of NEWS for key sepsis-related outcomes, including hyperlactatemia, ICU admission, and in-hospital mortality.

Main Methods:

• Retrospective chart review of 444 patients admitted under a sepsis management protocol over one year.
• NEWS was used as a primary screening tool in the triage area.
• Calculation of sensitivity, specificity, and Area Under the Curve (AUC) for NEWS in predicting predefined sepsis-related outcomes.

Main Results:

• A NEWS score of 5 or higher demonstrated over 88% sensitivity for predicting hyperlactatemia, ICU admission, and/or mortality.
• The specificity of NEWS for these outcomes was low, at only 12%.
• The AUC for NEWS was 0.667 for predicting hyperlactatemia and 0.602 for predicting ICU admission or mortality.

Conclusions:

• The National Early Warning Score (NEWS) is a highly sensitive tool for screening patients at risk of sepsis-related adverse outcomes in the emergency department.
• The low specificity of NEWS indicates a high rate of false positives, necessitating further investigation.
• Integration of additional clinical factors with NEWS is recommended to enhance its specificity and improve the accuracy of sepsis prediction in triage settings.