NEWS2 and the older person

Area of Science:

• Geriatric Medicine
• Clinical Assessment Tools
• Patient Safety

Background:

• The National Early Warning Score (NEWS) was established in 2012 without specific considerations for the older population.
• The revised NEWS2 (2017) introduced 'new confusion' as a consciousness assessment category.
• Older adults often present with atypical symptoms, posing challenges for standard clinical assessment tools.

Purpose of the Study:

• To evaluate the utility of NEWS2 in identifying acute clinical deterioration in older individuals.
• To explore how NEWS2 can guide care decisions and escalation strategies for the elderly.
• To assess the effectiveness and limitations of NEWS and NEWS2 in various care settings, including care homes.

Main Methods:

• Review of existing evidence on NEWS and NEWS2 performance in older populations.
• Analysis of NEWS2's role in clinical deterioration detection and care escalation.
• Consideration of NEWS2 application in diverse healthcare environments, including residential care.

Main Results:

• NEWS2 includes confusion as a factor, potentially improving its applicability to older patients.
• The score's utility in care homes requires further investigation, with potential benefits and limitations identified.
• Evidence suggests NEWS2 is a valuable tool but may not fully capture the complexity of illness in older adults.

Conclusions:

• NEWS2 shows promise for detecting acute deterioration in older people but may necessitate future modifications for this demographic.
• Integration of NEWS2 with other clinical assessments, such as the Clinical Frailty Scale and the 4AT for delirium, is recommended.
• Further research is needed to refine NEWS2 for optimal use in geriatric care, particularly in non-acute settings.