Almutary Abdulaziz, Althunayyan Saqer, Alenazi Khaled, Alqahtani Abdulrahman, Alotaibi Badar, Ahmed Marwa, Osman Isam S, Kakpuri Adil, Alanazi Abdulaziz, Arafat Mohammed, Al-Mutairi Abdulmajeed, Bashraheel Fatma, Almazroua Faisal
Emergency Department, King Saud Medical City, Riyadh, Saudi Arabia.
Department of Accident and Trauma, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia.
Infect Drug Resist. 2020 Oct 27;13:3843-3851. doi: 10.2147/IDR.S275390. eCollection 2020.
We assessed the National Early Warning Score (NEWS) in emergency triage for predicting sepsis-related outcomes.
A retrospective chart review of all cases enrolled in the sepsis management protocol for a one-year duration. The protocol utilized the NEWS as a screening tool for sepsis in the triage area. Primary outcomes of interest were hyperlactatemia, admission to ICU and intrahospital mortality. Sensitivity, specificity, and area under the curve (AUC) were calculated for a given NEWS.
A total of 444 patients were reviewed from July 2018 to June 2019, with a mean age of 58.7 years. A NEWS ≥5 was more than 88% sensitive in predicting hyperlactatemia, ICU admission, and/or mortality. Specificity, on the other hand, was as low as 12%. The AUC for the NEWS was 0.667 for predicting hyperlactatemia and 0.602 for predicting ICU admission or mortality.
The NEWS was a sensitive screening tool for predicting sepsis-related outcomes. However, it was not specific, and further studies are recommended to assess the integration of other factors to improve specificity.
我们评估了国家早期预警评分（NEWS）在急诊分诊中预测脓毒症相关结局的情况。
对纳入脓毒症管理方案一年期间的所有病例进行回顾性病历审查。该方案将NEWS用作分诊区域脓毒症的筛查工具。主要关注的结局是高乳酸血症、入住重症监护病房（ICU）和院内死亡率。针对给定的NEWS计算敏感性、特异性和曲线下面积（AUC）。
2018年7月至2019年6月共审查了444例患者，平均年龄58.7岁。NEWS≥5在预测高乳酸血症、入住ICU和/或死亡率方面的敏感性超过88%。另一方面，特异性低至12%。NEWS预测高乳酸血症的AUC为0.667，预测入住ICU或死亡率的AUC为0.602。
NEWS是预测脓毒症相关结局的敏感筛查工具。然而，它不具有特异性，建议进一步研究评估整合其他因素以提高特异性。
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