Mei Tianshu, Xia Ying, Huang Ping, Xiong Yali, Weng Yiwen, Wei Zhonghai, He Fei
Department of Emergency Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Department of Infectious Disease, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
J Clin Nurs. 2025 Jul;34(7):2992-3002. doi: 10.1111/jocn.17713. Epub 2025 May 20.
To investigate the association between the New Early Warning Score (NEWS) and 28-day mortality in patients with severe fever with thrombocytopenia syndrome (SFTS).
A cross-sectional derivation and validation study.
A total of 382 SFTS patients were included in retrospective and prospective studies. The primary outcome was short-term (28-day) mortality. Cox regression, receiver operating characteristic (ROC), and Kaplan-Meier analysis were utilised in the retrospective study to assess the association between NEWS and mortality. The prospective study assessed the applicability of the NEWS.
This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Among 219 SFTS patients in the retrospective study, 27 (12.3%) died within 28 days. NEWS was significantly higher in non-survivors than in survivors (4.00 [1.00, 5.00] vs. 1.00 [1.00, 2.00]). The ROC curve for MEWS predicting 28-day mortality showed an area under the curve (AUC) of 0.757 (95% confidence interval: 0.65-0.87), with a cut-off of 3.5 (sensitivity: 90.6%; specificity: 55.6%). SFTS patients were stratified into low (NEWS < 4), medium (NEWS 4-6), and high (NEWS > 6) risk groups. Kaplan-Meier analysis showed significantly lower survival rates in medium and high risk groups compared to the low risk group. The prospective study included 63 SFTS patients, of whom 11 (17.5%) died. 28-day mortality significantly increased across NEWS categories: [low risk (4/50, 8.0%), medium risk (4/8, 50.0%), high risk (3/5, 60.0%)].
NEWS was a quicker, simpler, and valuable parameter to identify SFTS patients at risk of 28-day mortality.
An elevated NEWS at admission is associated with a higher risk of poor short-term prognosis in SFTS patients. Incorporating NEWS into emergency nursing practice may aid in the early identification of SFTS patients at risk of adverse prognosis.
Emergency nurses performed the NEWS for the SFTS patients at admission.
探讨新型早期预警评分（NEWS）与发热伴血小板减少综合征（SFTS）患者28天死亡率之间的关联。
一项横断面推导与验证研究。
共有382例SFTS患者纳入回顾性和前瞻性研究。主要结局为短期（28天）死亡率。回顾性研究采用Cox回归、受试者工作特征曲线（ROC）及Kaplan-Meier分析来评估NEWS与死亡率之间的关联。前瞻性研究评估NEWS的适用性。
本研究按照加强流行病学观察性研究报告（STROBE）指南进行报告。
回顾性研究中的219例SFTS患者中，27例（12.3%）在28天内死亡。非幸存者的NEWS显著高于幸存者（4.00[1.00,5.00]对1.00[1.00,2.00]）。MEWS预测28天死亡率的ROC曲线下面积（AUC）为0.757（95%置信区间：0.65 - 0.87），截断值为3.5（灵敏度：90.6%；特异度：55.6%）。SFTS患者被分为低（NEWS<4）、中（NEWS 4 - 6）和高（NEWS>6）风险组。Kaplan-Meier分析显示，中、高风险组的生存率显著低于低风险组。前瞻性研究纳入63例SFTS患者，其中11例（17.5%）死亡。28天死亡率在各NEWS类别中显著增加：[低风险（4/50，8.0%）、中风险（4/8，50.0%）、高风险（3/5，60.0%）]。
NEWS是识别有28天死亡风险的SFTS患者的一个更快、更简单且有价值的参数。
入院时NEWS升高与SFTS患者短期预后不良风险较高相关。将NEWS纳入急诊护理实践可能有助于早期识别有不良预后风险的SFTS患者。
急诊护士在SFTS患者入院时进行NEWS评估。
