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首页> 外文期刊>Resuscitation. >A comparison of the ability of the National Early Warning Score and the National Early Warning Score 2 to identify patients at risk of in-hospital mortality: A multi-centre database study
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A comparison of the ability of the National Early Warning Score and the National Early Warning Score 2 to identify patients at risk of in-hospital mortality: A multi-centre database study

机译：国家预警成绩与国家预警分数2的能力比较，识别患有医院内死亡率的患者：多中心数据库研究

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Aims: To compare the ability of the National Early Warning Score (NEWS) and the National Early Warning Score 2 (NEWS2) to identify patients at risk of in-hospital mortality and other adverse outcomes. Methods: We undertook a multi-centre retrospective observational study at five acute hospitals from two UK NHS Trusts. Data were obtained from completed adult admissions who were not fit enough to be discharged alive on the day of admission. Diagnostic coding and oxygen prescriptions were used to identify patients with type II respiratory failure (T2RF). The primary outcome was in-hospital mortality within 24 h of a vital signs observation. Secondary outcomes included unanticipated intensive care unit admission or cardiac arrest within 24 h of a vital signs observation. Discrimination was assessed using the c-statistic. Results: Among 251,266 adult admissions, 48,898 were identified to be at risk of T2RF by diagnostic coding. In this group, NEWS2 showed statistically significant lower discrimination (c-statistic, 95% CI) for identifying in-hospital mortality within 24h (0.860, 0.857-0.864) than NEWS (0.881, 0.878-0.884). For 1394 admissions with documented T2RF, discrimination was similar for both systems: NEWS2 (0.841, 0.827-0.855), NEWS (0.862, 0.848-0.875). For all secondary endpoints, NEWS2 showed no improvements in discrimination. Conclusions: NEWS2 modifications to NEWS do not improve discrimination of adverse outcomes in patients with documented T2RF and decrease discrimination in patients at risk of T2RF. Further evaluation of the relationship between SpO2 values, oxygen therapy and risk should be investigated further before wide-scale adoption of NEWS2.
机译：旨在比较国家预警分数（新闻）和国家预警得分2（新闻2）的能力，以识别患有住院内死亡率和其他不利结果的患者。方法：我们在来自两个英国NHS信托的五家急性医院进行了多中心回顾性观察研究。从已完成的成人招生获得数据，他们不足以在入学日内才能排出。使用诊断编码和氧中处方用于鉴定II型呼吸衰竭（T2RF）的患者。主要结果是在医院的死亡率，在一个重要的迹象中观察到的24小时内。二次结果包括在一个重要的体征观察中的24小时内意外的重症监护单位入学或心脏骤停。使用C统计评估歧视。结果：251,266个成人入学中，48,898人被诊断编码识别出T2RF的风险。在该组中，News2显示出统计上显着的较低歧视（C统计，95％CI），用于识别24小时内的住院死亡率（0.860,0.857-0.864）（0.881,0.878-0.884）。对于记录的T2RF的1394个招生，系统的歧视类似：新闻2（0.841,0.827-0.855），新闻（0.862,0.848-0.875）。对于所有辅助端点，NEWS2没有改善歧视。结论：NEWS2对新闻的修改不会改善记录T2RF患者的不良结果的歧视，并降低了T2RF风险的患者的歧视。在大规模采用新闻2之前，应进一步调查SPO2值，氧气治疗和风险之间关系的进一步评价。

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