Predictive values of news and Mts in patients presenting with dyspnea: A comparative cohort study

Dyspnea is a frequent yet potentially life-threatening complaint in emergency departments. This study aimed to compare the predictive accuracy of the National Early Warning Score and the Manchester Triage System for key clinical outcomes among dyspneic ED patients.

We retrospectively analyzed 726 adult dyspneic patients presenting to a tertiary ED. Demographics, initial vital signs, MTS triage category, and calculated NEWS values were recorded at admission. Outcomes included hospital ward admission, intensive care unit admission, in-hospital mortality, 48-hour reattendance, and length of stay. Statistical analyses comprised chi-square, Kruskal-Wallis, and logistic regression models.

The mean age was 61.1 years, and 52.9% were female. Of the patients, 13.8% were admitted to wards, 3.2% to ICUs, and 2.3% died; 4.1% reattended within 48 hours. NEWS risk stratification strongly aligned with MTS categories (p<0.001). Higher NEWS scores were associated with older age, higher respiratory and pulse rates, lower blood pressure, and reduced oxygen saturation. NEWS independently predicted hospital admission (OR=4.47, p<0.001) and ICU admission (OR=1.94, p=0.001), whereas MTS predicted ICU admission (inverse association, OR=0.34, p<0.001) and mortality (OR=0.30, p<0.001).

NEWS more accurately predicted hospital and ICU admission, while MTS was more strongly associated with mortality in dyspneic ED patients. These complementary roles suggest that combining both tools-or developing a dyspnea-specific hybrid model-may enhance risk stratification and improve outcomes.