Kim Dong Ki, Lee Dong Hun, Lee Byung Kook
Emergency Department, Chonnam National University Hospital, Gwangju, Republic of Korea.
Emergency Department, Chonnam National University Medical School, Gwangju, Republic of Korea.
Heliyon. 2024 Mar 18;10(6):e28338. doi: 10.1016/j.heliyon.2024.e28338. eCollection 2024 Mar 30.
Geriatric patients arriving in a non-traumatic coma (NTC) at the emergency department (ED) present substantial risks and necessitate prompt and appropriate care. The National Early Warning Score (NEWS) is a promising tool that can efficiently evaluate this vulnerable population. Current study was designed to assess the effectiveness of the NEWS for predicting the severity of illness in geriatric patients with NTC and identifying those at highest risk. Current study was performed involving geriatric patients (aged ≥65 years) with NTC who visited Chonnam National University Hospital between January and December 2022. NEWS and Modified Early Warning Scores (MEWS) were calculated at ED visits. The association of NEWS and MEWS for in-hospital death was evaluated by multivariable analysis. Out of 683 patients, 202 were non-survivors (29.6%). The NEWS and MEWS values of non-survivors were higher than those of survivors (NEWS, 7 [5-10] vs. 10 [8-12]; MEWS, 5 [4-6] vs. 7 [5-8]). The NEWS (adjusted odds ratio [aOR]; 1.253, 95% confidence interval [CI]: 1.181-1.329) and MEWS (aOR; 1.323, 95% CI: 1.206-1.451) were also significantly associated with in-hospital death. The area under the curve for the NEWS and MEWS was 0.721 (95% CI: 0.685-0.754) and 0.695 (95% CI: 0.659-0.730), respectively. The NEWS can be an effective tool for predicting severity of illness via in-hospital death in geriatric patients with NTC.
老年患者在急诊科出现非创伤性昏迷（NTC）存在重大风险，需要及时且恰当的护理。国家早期预警评分（NEWS）是一种很有前景的工具，可有效评估这一脆弱人群。本研究旨在评估NEWS在预测老年NTC患者疾病严重程度及识别高危患者方面的有效性。本研究纳入了2022年1月至12月期间在全南国立大学医院就诊的老年NTC患者（年龄≥65岁）。在急诊科就诊时计算NEWS和改良早期预警评分（MEWS）。通过多变量分析评估NEWS和MEWS与院内死亡的相关性。683例患者中，202例死亡（29.6%）。死亡患者的NEWS和MEWS值高于存活患者（NEWS，7[5 - 10]对10[8 - 12]；MEWS，5[4 - 6]对7[5 - 8]）。NEWS（调整后比值比[aOR]；1.253，95%置信区间[CI]：1.181 - 1.329）和MEWS（aOR；1.323，95%CI：1.206 - 1.451）也与院内死亡显著相关。NEWS和MEWS的曲线下面积分别为0.721（95%CI：0.685 - 0.754）和0.695（95%CI：0.659 - 0.730）。NEWS可作为预测老年NTC患者院内死亡疾病严重程度的有效工具。
