J Korean Soc Emerg Med.  2019 Dec;30(6):563-568. 10.0000/jksem.2019.30.6.563.

Is the National Early Warning Score applicable to patients with trauma?

• Suh JH
• Kim DH
• Kang C
• Lee SH
• Jeong JH
• Kim T
• Lee SB
• Kim SC

• KMID: 2470547
• DOI: http://doi.org/10.0000/jksem.2019.30.6.563

Abstract

OBJECTIVE
The National Early Warning Score (NEWS) is used widely to detect deteriorating patients in a range of clinical situations. This study examined the ability of the NEWS to predict poor outcomes in trauma patients.
METHODS
This was a retrospective observational study using a dataset collected prospectively from trauma patients who visited the emergency department of a tertiary referral center in the southern area of the Republic of Korea. The area under the receiver operating curves (AUC) of the Revised Trauma Score (RTS) and NEWS were compared. The primary outcome was in-hospital mortality.
RESULTS
Among 17,661 patients finally enrolled, 66.3% were male, and the median age was 49 (34-64). The AUC of the NEWS and RTS were 0.878 (95% confidence interval [CI], 0.873-0.883) and 0.827 (95% CI, 0.821-0.833) (AUC difference, 0.051; 95% CI, 0.025-0.077; P<0.01), respectively. The sensitivity and specificity of the NEWS were 74.0% and 91.2%, respectively, at a cutoff of four, and those of the RTS were 67.7% and 96.1%, respectively, at 7.55.
CONCLUSION
The NEWS showed better performance in predicting the in-hospital mortality of patients with trauma compared to the RTS.

Keyword

Mortality; National Early Warning Score; Revised Trauma Score; Emergency department

MeSH Terms

Area Under Curve
Dataset
Emergency Service, Hospital
Hospital Mortality
Humans
Male
Mortality
Observational Study
Prospective Studies
Republic of Korea
Retrospective Studies
Sensitivity and Specificity
Tertiary Care Centers