Luo Zhen, Peng Xiaobei, Zhou Fangyi, Zhang Lei, Guo Mengwei, Peng Lingli
Xiangya Nursing School, Central South University, Changsha, China.
Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.
Nurs Crit Care. 2023 May;28(3):388-395. doi: 10.1111/nicc.12739. Epub 2021 Dec 9.
The coronavirus disease 2019 (COVID-19) pandemic has spread globally and caused a major worldwide health crisis. Patients who are affected more seriously by COVID-19 usually deteriorate rapidly and need further intensive care.
We aimed to assess the performance of the National Early Warning Score 2 (NEWS2) as a risk stratification tool to discriminate newly admitted patients with COVID-19 at risk of serious events.
We conducted a retrospective single-centre case-control study on 200 unselected patients consecutively admitted in March 2020 in a public general hospital in Wuhan, China.
The following serious events were considered: mortality, unplanned intensive care unit (ICU) admission, and non-invasive ventilation treatment. Receiver operating characteristic (ROC) analysis and logistic regression analysis were used to quantify the association between outcomes and NEWS2.
There were 12 patients (6.0%) who had serious events, where 7 patients (3.5%) experienced unplanned ICU admissions. The area under the ROC curve (AUROC) and cut-off of NEWS2 for the composite outcome were 0.83 and 3, respectively. For patients with NEWS2 ≥ 4, the odds of being at risk for serious events was 16.4 (AUROC = 0.74), while for patients with NEWS2 ≥ 7, the odds of being at risk for serious events was 18.2 (AUROC = 0.71).
NEWS2 has an appropriate ability to triage newly admitted patients with COVID-19 into three levels of risk: low risk (NEWS2 = 0-3), medium risk (NEWS2 = 4-6), and high risk (NEWS2 ≥ 7).
Using NEWS2 may help nurses in early identification of at-risk COVID-19 patients and clinical nursing decision-making. Using NEWS2 to triage new patients with COVID-19 may help nurses provide more appropriate level of care and medical resources allocation for patients safety.
2019冠状病毒病（COVID-19）大流行已在全球蔓延，并引发了一场重大的全球健康危机。受COVID-19影响更严重的患者通常病情迅速恶化，需要进一步的重症监护。
我们旨在评估国家早期预警评分2（NEWS2）作为一种风险分层工具，用于区分新入院的有严重事件风险的COVID-19患者的性能。
我们对2020年3月在中国武汉一家公立综合医院连续收治的200例未经筛选的患者进行了一项回顾性单中心病例对照研究。
考虑以下严重事件：死亡率、非计划入住重症监护病房（ICU）和无创通气治疗。采用受试者操作特征（ROC）分析和逻辑回归分析来量化结局与NEWS2之间的关联。
有12例患者（6.0%）发生了严重事件，其中7例患者（3.5%）非计划入住了ICU。复合结局的ROC曲线下面积（AUROC）和NEWS2的临界值分别为0.83和3。对于NEWS2≥4的患者，发生严重事件的风险比值为16.4（AUROC = 0.74），而对于NEWS2≥7的患者，发生严重事件的风险比值为18.2（AUROC = 0.71）。
NEWS2有适当的能力将新入院的COVID-19患者分为三个风险级别：低风险（NEWS2 = 0 - 3）、中风险（NEWS2 = 4 - 6）和高风险（NEWS2≥7）。
使用NEWS2可能有助于护士早期识别有风险的COVID-19患者并进行临床护理决策。使用NEWS2对新入院的COVID-19患者进行分诊可能有助于护士为患者安全提供更适当的护理水平和医疗资源分配。
