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Objectives: The national early warning score (NEWS) was introduced to improve the detection of, and standardise the assessment of, the severity of acute illness in the National Health Service (NHS). We assessed whether the recommended threshold trigger score of 5 or more in a Critical Care Outreach Team (CCOT) review could accurately predict patients at risk of deterioration following cardiac surgery and patient outcomes. Methods: We investigated adult cardiac surgery patients between October 2019 and December 2021. NEWS 2 parameters triggering CCOT referrals and NEWS 2 parameters < 5 versus ≥5 were compared, and the resulting patient outcomes were evaluated. Results: Over this period, 3710 patients underwent surgery, of whom 162 (4.4%) initiated 193 calls to the CCOT. The mean number of NEWS 2 parameters on CCOT activation was 6.14 ± 2.43 (NEWS 0–16); 34 (20.98%) activations were from patients with NEWS 2 < 5. Low oxygen saturation (SpO2) (59.3%) and oxygen therapy (83.3%) were the most common physiological parameters raising the score. CCOT activations led to 38 transfers from the ward to the high-dependency unit (HDU) and 18 transfers to the intensive therapy unit (ITU). Cardiac arrest calls were initiated in 12 (7.40%) patients and two culminated in death. Fourteen (8.64%) had emergency resternotomy. The in-hospital mortality rate was 10.5% (17/162) in patients referred to CCOT versus 3.9% (139/3548) in patients who were not (p < 0.001). The in-hospital mortality in patients with NEWS 2 < 5 vs. NEWS ≥ 5 was 17.6% (6/34) versus 8.6% (11/128) (p = 0.126). Conclusions: There was no difference in in-hospital mortality in patients below or above a NEWS 2 of 5, but there was a significant difference in in-hospital mortality in patients reviewed by the CCOT (p < 0.001). Tailoring the threshold score specifically for the cardiac surgical cohort, in conjunction with clinician involvement, may improve outcomes. [ABSTRACT FROM AUTHOR]

The national early warning score (NEWS) is an appropriate tool for assessing patients experiencing catastrophic deterioration and enabling prompt intervention. The present study was carried out to assess the applicability of the NEWS in emergency departments and follow-up patients in the ICU in an Indian scenario. Methods: The study was conducted involving 270 patients of either sex and age greater than 16 years selected by simple random sampling. The data, which includes respiration rate, pulse rate, temperature, oxygen saturations, systolic blood pressure, and degree of consciousness, was gathered using the National Early Warning Score. Results: The mean age was 56.4 ± 16.9 years. The gender distribution was almost equal, with 53.7% male and 46.3% female. NEWS was 1-4 in 25.9% of subjects. 5-6 in 28.1% subjects and >/=7 in 45.9% subjects. The mean NEWS was 6.5 ± 2.9. Mortality was 22.6%, 75.9% of subjects were discharged, and 1.5% were referred. Apart from blood pressure and urine output, none of the parameters were found to be significantly different, including NEWS, between subjects with outcomes of death and discharge. The NEWS cut-off of 7.5 was found to predict mortality with 63.4% sensitivity and 49.2% specificity. Conclusion: NEWS effectively identifies subjects in need of immediate medical attention and paves the way for the development of a nationally validated scoring system to assess and convey the condition of subjects at intra- and inter-hospital facilities. [ABSTRACT FROM AUTHOR]

Abstract Background Coronavirus disease 2019 (COVID‐19) infection has a wide range of severity, ranging from asymptomatic infection to severe respiratory distress and multiple organ dysfunction. To optimize the utilization of limited resources, a system is needed to rapidly classify the patients requiring monitoring and urgent intervention. The purpose of this study was to determine whether the National Early Warning Score (NEWS) at admission is a useful prediction tool for in‐hospital mortality in patients who visited the emergency department (ED) and required isolation during the COVID‐19 pandemic. Methods This study was conducted in adults aged 19 years or older who visited the ED and were preemptively isolated due to fever or respiratory symptoms from January 2021 to December 2021. The NEWS was calculated at the time of ED admission. The primary outcome was all‐cause in‐hospital mortality. Results Of the 6304 patients included in the study, 5759 survived and 545 died in the hospital. The NEWS was higher in non‐survivors (6.1 ± 4.2) than in survivors (2.8 ± 2.5). When the NEWS was examined as a continuous variable, the adjusted odds ratio for in‐hospital mortality was 1.176 (95% CI, 1.12–1.23). The area under the curve (AUC) of NEWS for predicting in‐hospital mortality was 0.756 (95% CI, 0.734–0.778). Conclusions The NEWS at ED admission was associated with in‐hospital mortality in preemptively isolated patients during the COVID‐19 pandemic. The use of NEWS in patients with suspected COVID‐19 infection would help predict the severity and prognosis of patients.

Abstract Background In the UK National Health Service (NHS), the patient’s vital signs are monitored and summarised into a National Early Warning Score (NEWS) score. A set of computer-aided risk scoring systems (CARSS) was developed and validated for predicting in-hospital mortality and sepsis in unplanned admission to hospital using NEWS and routine blood tests results. We sought to assess the accuracy of these models to predict the risk of COVID-19 in unplanned admissions during the first phase of the pandemic. Methods Adult ( > = 18 years) non-elective admissions discharged (alive/deceased) between 11-March-2020 to 13-June-2020 from two acute hospitals with an index NEWS electronically recorded within ± 24 h of admission. We identified COVID-19 admission based on ICD-10 code ‘U071’ which was determined by COVID-19 swab test results (hospital or community). We assessed the performance of CARSS (CARS_N, CARS_NB, CARM_N, CARM_NB) for predicting the risk of COVID-19 in terms of discrimination (c-statistic) and calibration (graphically). Results The risk of in-hospital mortality following emergency medical admission was 8.4% (500/6444) and 9.6% (620/6444) had a diagnosis of COVID-19. For predicting COVID-19 admissions, the CARS_N model had the highest discrimination 0.73 (0.71 to 0.75) and calibration slope 0.81 (0.72 to 0.89) compared to other CARSS models: CARM_N (discrimination:0.68 (0.66 to 0.70) and calibration slope 0.47 (0.41 to 0.54)), CARM_NB (discrimination:0.68 (0.65 to 0.70) and calibration slope 0.37 (0.31 to 0.43)), and CARS_NB (discrimination:0.68 (0.66 to 0.70) and calibration slope 0.56 (0.47 to 0.64)). Conclusions The CARS_N model is reasonably accurate for predicting the risk of COVID-19. It may be clinically useful as an early warning system at the time of admission especially to triage large numbers of unplanned admissions because it requires no additional data collection and is readily automated.

BACKGROUND: Population aging is a social problem that is being faced in most countries. OBJECTIVE: To apply the National Early Warning Score (NEWS) for an early warning on the vital signs and consciousness of elderly patients who are hospitalized in the gastrointestinal surgical department and to provide a reference for early detection of changes in illness severity in elderly patients by studying the correlation between NEWS value and changes in illness severity. METHODS: We enrolled 528 elderly patients who were hospitalized in the gastrointestinal surgical department of a tertiary grade A hospital in Guizhou Province between June 2020 and May 2021, to analyze how NEWS max value correlates with illness severity and obtain the optimal NEWS cutoff value for both potentially critically ill and critically ill elderly patients using the receiver operating characteristic (ROC) curve. RESULTS: There were statistically significant differences in NEWS values between elderly patients with various illness severities (P < 0.05). NEWS values correlated positively with illness severity (r = 0.605, P < 0.001). Based on the ROC curve, early warning trigger values for NEWS to identify potentially critically ill, critically ill and terminally ill elderly patients were 6, 7 and 8, respectively. The area under the curve (AUC) for potentially critically ill, critically ill and terminally ill elderly patients was 0.907, 0.921 and 0.939, respectively. NEWS performed better in detecting patient illness severity than Modified Early Warning Score (MEWS) in AUC, sensitivity, specificity, and Youden's index, with statistically significant differences (P < 0.05). CONCLUSION: An early warning on the vital signs and consciousness of hospitalized elderly patients using NEWS can facilitate advanced detection of changes in illness severity of elderly patients by medical staff and enable timely treatment, thus significantly lowering the risks of illness deterioration. [ABSTRACT FROM AUTHOR]

Background In the UK National Health Service (NHS), the patient’s vital signs are monitored and summarised into a National Early Warning Score (NEWS) score. A set of computer-aided risk scoring systems (CARSS) was developed and validated for predicting in-hospital mortality and sepsis in unplanned admission to hospital using NEWS and routine blood tests results. We sought to assess the accuracy of these models to predict the risk of COVID-19 in unplanned admissions during the first phase of the pandemic. Methods Adult (>=18 years) non-elective admissions discharged (alive/deceased) between 11-March-2020 to 13-June-2020 from two acute hospitals with an index NEWS electronically recorded within ±24 h of admission. We identified COVID-19 admission based on ICD-10 code ‘U071’ which was determined by COVID-19 swab test results (hospital or community). We assessed the performance of CARSS (CARS_N, CARS_NB, CARM_N, CARM_NB) for predicting the risk of COVID-19 in terms of discrimination (c-statistic) and calibration (graphically). Results The risk of in-hospital mortality following emergency medical admission was 8.4% (500/6444) and 9.6% (620/6444) had a diagnosis of COVID-19. For predicting COVID-19 admissions, the CARS_N model had the highest discrimination 0.73 (0.71 to 0.75) and calibration slope 0.81 (0.72 to 0.89) compared to other CARSS models: CARM_N (discrimination:0.68 (0.66 to 0.70) and calibration slope 0.47 (0.41 to 0.54)), CARM_NB (discrimination:0.68 (0.65 to 0.70) and calibration slope 0.37 (0.31 to 0.43)), and CARS_NB (discrimination:0.68 (0.66 to 0.70) and calibration slope 0.56 (0.47 to 0.64)). Conclusions The CARS_N model is reasonably accurate for predicting the risk of COVID-19. It may be clinically useful as an early warning system at the time of admission especially to triage large numbers of unplanned admissions because it requires no additional data collection and is readily automated. [ABSTRACT FROM AUTHOR]

This work aimed to investigate the adoption value of blood lactic acid (BLA) combined with the National Early Warning Score (NEWS) in the early screening of sepsis patients and assessing their severity. The data and materials utilized in this work were obtained from the electronic medical record system of 537 anonymized sepsis patients who received emergency rescue in the emergency rescue area of Liuzhou People's Hospital, Guangxi, from July 1, 2020, to December 26, 2020. Based on the 28-day outcomes of sepsis patients, the medical records were rolled into Group S (407 survival cases) and Group D (130 dead cases). Basic information such as the mode of hospital admission, initial management, use of emergency ventilator within 24 h of admission, NEWS score, arterial oxygen pressure/alveolar oxygen pressure ratio (PaO2/PAO2), alveolar-arterial oxygen difference (A-aDO2), serum creatinine (SCr), blood urea nitrogen (BUN), oxygenation index (OI), Glasgow Coma Scale (GCS), D-dimer, use of vasoactive drugs within 24 h of admission, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), N-terminal pro-B-type natriuretic peptide (NT-proBNP), quick Sequential Organ Failure Assessment (qSOFA) score, SOFA score, BLA level, NEWS with lactate (NEWS-L) score, SOFA score including lactate level (SOFA-L) score, Intensive Care Unit (ICU) length of stay, total hospital stay, ICU stay/total hospital stay, and septic shock condition were compared between groups. Logistic regression analysis was performed to assess the impact of various predictive factors on prognosis and to plot the receiver operating characteristic (ROC) curve. The results suggested marked differences between Group S and Group D in terms of mean age (t = −5.620; OR = −9.96, 95 % CI: −13.44∼-6.47; P

Introduction: Few scoring systems are used in the emergency department to identify critically ill patients and anticipate patients' deterioration such as National Early Warning Score (NEWS). This study aimed to evaluate NEWS in patients with acute stroke and its relationship with treatment and type of stroke and patient outcome.Methods: In this prospective cross-sectional descriptive-analytical study, all patients over 18 years of age with a diagnosis of ischemic stroke, who presented through the emergency department, were involved. The variables of interest were collected; the NEWs score was calculated for each patient.Results: In assessing NEWS and its relationship with outcome based on the ROC curve, the area under the curve was equal to 0.417. Considering the high intensity of NEWS above 7, sensitivity, specificity, positive predictive value, negative predictive value, PLR, and NLR were 16.67%, 98.77%, 83.33%, 74.45%, 13.5, 0.84 respectively. In assessing NEWS and its relationship with stroke type on the ROC curve, the (AUC) was equal to 0.526. Considering the high intensity of NEWS above 7, sensitivity, specificity, positive predictive value, negative predictive value, PLR, and NLR were 8.33%, 94.95%, 16.67%, 88.53%, 1.65, and 0.97 respectively.Conclusion: In terms of outcome, NEWS seems to have acceptable specificity and positive and negative predictive values. Regarding the type of stroke, NEWS has an acceptable specificity but it only has a negative predictive value about the non-hemorrhagic type of stroke. This means that if the NEWS number is LOW, the probability is that the type of stroke is ischemic and the patient outcome is good.

Pap smear is a digital image generated from the recording of cervical cancer cell preparation. Images generated are susceptible to errors due to relatively small cell sizes and overlapping cell nuclei. Therefore, an accurate analysis of the Pap smear image is essential to obtain the right information. This research compares nucleus segmentation and detection using gray-level cooccurrence matrix (GLCM) features in two methods: Otsu and polynomial. The data tested consisted of 400 images sourced from RepoMedUNM, a publicly accessible repository containing 2,346 images. Both methods were compared and evaluated to obtain the most accurate characteristics. The research results showed that the average distance of the Otsu method was 6.6457, which was superior to the polynomial method with a value of 6.6215. Distance refers to the distance between the nucleus detected by the Otsu and the Polynomial method. Distance is an important measure to assess how closely the detection results align with the actual nucleus positions. It indicates that the polynomial method produces nucleus detections that are on average closer to the actual nucleus positions compared to the Otsu method. Consequently, this research can serve as a reference for future studies in developing new methods to enhance identification accuracy.

In 2012, the National Early Warning Score (NEWS) was introduced to standardise monitoring of vital signs and improve patient safety in acute hospitals. By 2017 around two-thirds of NHS hospitals were using NEWS and an updated version, NEWS2, was released. In 2019 all acute hospital trusts and ambulance services were required to use NEWS2. Now NEWS2 is being used increasingly in care homes and community settings. People living in care homes are often frail and have multiple healthcare conditions. NEWS was never designed to monitor the health of older people, but it has the potential to improve care by enabling staff to identify people who are becoming unwell and to provide care within care homes and the person's own home. However, if it is not introduced with care, it could lead to an increase in the number of people attending accident and emergency departments. This article examines the emerging evidence base and concludes that appropriate support and advanced care planning are of crucial importance. [ABSTRACT FROM AUTHOR]

Previous studies have shown that an elevated prehospital National Early Warning Score (preNEWS) is associated with increased levels of adverse outcomes in patients with trauma. However, whether preNEWS is a predictor of massive transfusion (MT) in patients with trauma is currently unknown. This study investigated the accuracy of preNEWS in predicting MT and hospital mortality among trauma patients. We analyzed adult trauma patients who were treated and transported by emergency medical services (EMS) between January 2018 and December 2019. The main exposure was the preNEWS calculated for the scene. The primary outcome was the predictive ability for MT, and the secondary outcome was 24 h mortality. We compared the prognostic performance of preNEWS with the shock index, modified shock index, and reverse shock index, and reverse shock index multiplied by Glasgow Coma Scale in the prehospital setting. In total, 41,852 patients were included, and 1456 (3.5%) received MT. preNEWS showed the highest area under the receiver operating characteristic (AUROC) curve for predicting MT (0.8504; 95% confidence interval [CI], 0.840–0.860) and 24 h mortality (AUROC 0.873; 95% CI, 0.863–0.883). The sensitivity of preNEWS for MT was 0.755, and the specificity of preNEWS for MT was 0.793. All indicies had a high negative predictive value and low positive predictive value. preNEWS is a useful, rapid predictor for MT and 24 h mortality. Calculation of preNEWS would be helpful for making the decision at the scene such as transfer straightforward to trauma center and advanced treatment. [ABSTRACT FROM AUTHOR]

We sought to validate prognostic scores in coronavirus disease 2019 including National Early Warning Score, Modified Early Warning Score, and age-based modifications, and define their performance characteristics.DesignWe analyzed prospectively collected data from the Adaptive COVID-19 Treatment Trial. National Early Warning Score was collected daily during the trial, Modified Early Warning Score was calculated, and age applied to both scores. We assessed prognostic value for the end points of recovery, mechanical ventilation, and death for score at enrollment, average, and slope of score over the first 48 hours.SettingA multisite international inpatient trial.PatientsA total of 1,062 adult nonpregnant inpatients with severe coronavirus disease 2019 pneumonia.InterventionsAdaptive COVID-19 Treatment Trial 1 randomized participants to receive remdesivir or placebo. The prognostic value of predictive scores was evaluated in both groups separately to assess for differential performance in the setting of remdesivir treatment.Measurements and main resultsFor mortality, baseline National Early Warning Score and Modified Early Warning Score were weakly to moderately prognostic (c-index, 0.60-0.68), and improved with addition of age (c-index, 0.66-0.74). For recovery, baseline National Early Warning Score and Modified Early Warning Score demonstrated somewhat better prognostic ability (c-index, 0.65-0.69); however, National Early Warning Score+age and Modified Early Warning Score+age further improved performance (c-index, 0.68-0.71). For deterioration, baseline National Early Warning Score and Modified Early Warning Score were weakly to moderately prognostic (c-index, 0.59-0.69) and improved with addition of age (c-index, 0.63-0.70). All prognostic performance improvements due to addition of age were significant (p < 0.05).ConclusionsIn the Adaptive COVID-19 Treatment Trial 1 cohort, National Early Warning Score and Modified Early Warning Score demonstrated moderate prognostic performance in patients with severe coronavirus disease 2019, with improvement in predictive ability for National Early Warning Score+age and Modified Early Warning Score+age. Area under receiver operating curve for National Early Warning Score and Modified Early Warning Score improved in patients receiving remdesivir versus placebo early in the pandemic for recovery and mortality. Although these scores are simple and readily obtainable in myriad settings, in our data set, they were insufficiently predictive to completely replace clinical judgment in coronavirus disease 2019 and may serve best as an adjunct to triage, disposition, and resourcing decisions.

Introduction: Overcrowding in emergency departments (ED) is a global concern, emphasizing the need for effective resource allocation. Triage plays a crucial role in prioritizing patients based on medical needs. This study aimed to evaluate the accuracy of National Early Warning Score (NEWS) in predicting the ED patients’ outcomes. Methods: A cross-sectional study was conducted in two tertiary hospitals in Tehran, Iran, from June to July 2023. Adult patients presenting to ED were included. Data for calculating the NEWs and emergency severity index (ESI), as well as outcomes were recorded by trained nurses, and then the accuracy of each score in predicting the outcomes was evaluated. Results: A total of 2,085 patients were analyzed. The majority were male (57%) with a mean age of 54.4 years. The primary outcome, cardiopulmonary resuscitation (CPR) within 24 hours of admission, occurred in 1.9% of patients, while the need for intensive care unit (ICU) care and/or mechanical ventilation happened in 3.4%, and CPR or need for ICU care and/or mechanical ventilation was observed in 4.3% of studied cases. Each one-point increase in NEWS was associated with a 52% higher likelihood of CPR (95% confidence interval (CI): 1.41 to 1.65, p

Objective To investigate the value of serum soluble intercellular adhesion molecule-1（sICAM-1) level combined with National Early Warning Score (NEWS) in assessing the prognosis of patients with acute respiratory distress syndrome (ARDS) due to severe pneumonia (SP) . Methods Totally 121 patients with ARDS due to SP were selected and divided into the death group and survival group according to whether they died at 28 d. Serum sICAM-1 levels were measured and NEWS scores were calculated. Multi-factor Logistic regression was used to analyze the factors affecting death in patients with ARDS due to SP, and ROC curves were used to analyze the predictive value of serum sICAM-1 levels and NEWS scores on death in patients with ARDS due to SP. Results They were followed up after 28 days，37 cases died (death group), the mortality rate was 30. 58% (37/121), and 84 cases survived (survival group) . Compared with the survival group, the serum sICAM-1 level and NEWS scores increased in the death group (all P < 0. 05) . Multi-factor Logistic regression analysis showed that sICAM-1（OR=1. 004，95% CI：1. 002 to 1. 007) and NEWS score (OR=2. 163, 95% CI：1. 374 to 3. 405) were independent risk factors for death in SP-induced ARDS patients, and oxygenation index (OR=0. 963，95% CI：0. 939 to 0. 988) was an independent protective factor (all P<0. 05) . ROC curve analysis showed that the area under the curve (AUC) of serum sICAM-1 combined with NEWS score (AUC = 0. 883，95% CI：0. 812 to 0. 934) in predicting death in patients with ARDS due to SP was greater than those of sICAM-1（AUC = 0. 783，95% CI： 0. 699 to 0. 853) or NEWS score (AUC = 0. 797，95% CI：0. 715 to 0. 865) alone (both P<0. 05) . Conclusion Serum sICAM-1 and NEWS scores were independently associated with the prognosis of patients with ARDS due to SP, and serum sICAM-1 combined with NEWS scores were of high value in predicting death in patients with ARDS due to SP. [ABSTRACT FROM AUTHOR]

Ar-aishah Dadeh, Matina Kulparat Department of Emergency Medicine, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, ThailandCorrespondence: Ar-aishah Dadeh, Department of Emergency Medicine, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand, Tel +6674-451705, Fax +6674-451704, Email dadehstou@gmail.comObjective: We aimed to evaluate the National Early Warning Score‒Lactate (NEWS‒L) and NEWS to predict 24-hour mortality as the primary outcome. The secondary outcomes were to predict 48-hour, 28-day, and in-hospital mortality rates, and the need for critical care in patient with suspicion of sepsis at the emergency department (ED).Methods: A prospective observational study was performed in patients aged ≥ 18 years diagnosed with sepsis in the ED from March to November 2021. Area under the receiver operating characteristic curve (AUROC) analyses determined the predictive values of NEWS and NEWS‒L for 24-hour mortality.Results: Ninety-two patients were enrolled (mean age 68 years, 48 [52.2%] males). Three (3.2%) patients died within 24 hours and 34 (36.9%) patients needed critical care during the ED stay. The median (interquartile range) NEWS and NEWS-L results were higher in the 24-hour non-survivors versus survivors: 12 (10.5, 12.5) versus 8 (6, 9) (p = 0.024) and 18.7 (15.2, 19.1) versus 10.6 (8.9, 13) (p = 0.036), respectively. The adjusted odds ratio (aOR) was 1.22 for the primary outcome as the NEWS-L increased by 1 unit without statistical significance (p = 0.228). The aOR values for the secondary outcomes ranged from 1.34 to 1.67 with statistical significance. A NEWS-L of 11 and a NEWS of 12 predicted 24-hour mortality with sensitivities/specificities of 100%/56% and 67%/91%, respectively. The AUROC values of NEWS-L for mortality at 24 hours, 48 hours, 28 days, and in-hospital patients, and the need for critical care were 0.860, 0.905, 0.813, 0.839, and 0.837, respectively.Conclusion: NEWS-L is an accurate predictor for 24-hour mortality in septic patients in the ED. NEWS‒L performed better than NEWS for each outcome. NEWS‒L demonstrated good to excellent performance and was accurate in predicting sepsis related to adverse outcomes.Keywords: National Early Warning Score, NEWS, NEWS-lactate, sepsis, mortality, need for critical care

Sarcopenia is more common in the elderly and causes adverse outcomes with increased morbidity and mortality. This prospective cohort study assessed the association of sarcopenia risk with the severity of COVID-19 at the time of admission and during hospitalisation and the length of hospital stay. Two hundred patients (aged ≥ 60 years) who were hospitalised for COVID-19 were enrolled using consecutive sampling between 29 December 2020 and 20 May 2021. The sarcopenia score of the patients was assessed using the Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls questionnaire. The severity of COVID-19 was determined using the modified National Early Warning Score (m-NEWS) system for 2019 n-CoV-infected patients at admission (T1), day three (T2) and at discharge (T3). Data were analysed using SPSS, version 22 and STATA, version 14. Of the 165 patients included, thirty four (20·6 %) were at risk of sarcopenia. The length of hospital stay was slightly longer in patients with sarcopenia risk, but the difference was not significant (P = 0·600). The adjusted OR of respiratory rate (RR) > 20 /min at T1 for the sarcopenia risk group was 6·7-times higher than that for the non-sarcopenic group (P = 0·002). According to generalised estimating equations, after adjusting for confounding factors, the m-NEWS score was 5·6 units higher in patients at risk of sarcopenia (P < 0·001). Sarcopenia risk could exacerbate COVID-19 severity and increase RR at admission, as well as the need for oxygen therapy at discharge. [ABSTRACT FROM AUTHOR]

Data on patient characteristics and determinants of serious outcomes for acutely admitted patients with infections who do not fulfill the sepsis criteria are sparse. The study aimed to characterize acutely admitted emergency department (ED) patients with infections and a composite outcome of in-hospital mortality or transfer to the intensive care unit without fulfilling the criteria for sepsis and to examine predictors of the composite outcome. This was a secondary analysis of data from a prospective observational study of patients with suspected bacterial infection admitted to the ED between October 1, 2017 and March 31, 2018. A National Early Warning Score 2 (NEWS2) ≥ 5 within the first 4 h in the ED was assumed to represent a sepsis-like condition with a high risk for the composite endpoint. Patients who achieved the composite outcome were grouped according to fulfillment of the NEWS2 ≥ 5 criteria. We used logistic regression analysis to estimate the unadjusted and adjusted odds ratio (OR) for the composite endpoint among patients with either NEWS2 < 5 (NEWS2-) or NEWS2 ≥ 5 (NEWS2+). A total of 2055 patients with a median age of 73 years were included. Of these, 198 (9.6%) achieved the composite endpoint, including 59 (29.8%) NEWS2- and 139 (70.2%) NEWS2+ patients, respectively. Diabetes (OR 2.23;1.23–4.0), a Sequential Organ Failure Assessment (SOFA) score ≥ 2 (OR 2.57;1.37–4.79), and a Do-not-attempt-cardiopulmonary-resuscitation order (DNACPR) on admission (OR 3.70;1.75–7.79) were independent predictive variables for the composite endpoint in NEWS2- patients (goodness-of-fit test P = 0.291; area under the receiver operating characteristic curve for the model (AUROC) = 0.72). The regression model for NEWS2+ patients revealed that a SOFA score ≥ 2 (OR 2.79; 1.59–4.91), hypothermia (OR 2.48;1.30–4.75), and DNACPR order on admission were predictive variables for the composite endpoint (goodness-of-fit test P = 0.62; AUROC for the model = 0.70). Approximately one-third of the patients with infections and serious outcomes during hospitalization did not meet the NEWS2 threshold for likely sepsis. Our study identified factors with independent predictive values for the development of serious outcomes that should be tested in future prediction models. [ABSTRACT FROM AUTHOR]

Background: Clinical deterioration in critically ill patients is a common phenomenon that can occur several hours before an adverse outcome. Early detection of subtle changes in vital signs, such as alterations in pulse rate and blood pressure, is crucial for preventing adverse events. However, these are not often recognized early enough to prompt quick intervention. The use of warning scores or assessment systems in the management of the critically ill in Nigeria has not been well evaluated. We assessed the association between the National Early Warning Score (NEWS) system and outcomes particularly mortality among the critically ill at the Jos University Teaching Hospital (JUTH), Nigeria. Methodology: This study is a retrospective study involving adults admitted to the medical and surgical wards between January 2021 and July 2021. The records of all patients admitted to inpatient care at JUTH during a 6-month period were reviewed. Patient medical records were used to obtain data such as socio-demographics, and vital signs, which were used to compute the NEWS variable, diagnosis, length of stay, outcomes, and complications. Patients were classified as low, medium, and high-risk based on their NEWS scores within the first 24 hours of admission and 24 hours prior to the outcome of interest (death or discharge). The study received ethical approval from the human research and ethics committee at JUTH. Results: A total of 405 patients were included in this study. Patients with low, medium, and high-risk NEWS scores within the first 24 hours of admission, had an 11.1%, 9%, and 17% chance of death respectively. In the NEWS score high-risk group 24 hours prior to outcome (death or discharge), the risk of mortality increased to 20.6% and there was a four-fold increase in odds of death. Conclusion: Our results showed that the NEWS score predicted outcome and may suggest that the implementation of the NEWS score as a routine tool for monitoring inpatients at the Jos University Teaching Hospital could help to detect patients at risk of adverse events. [ABSTRACT FROM AUTHOR]

Abstract Background Clinical risk scores are widely used in emergency medicine, and some studies have evaluated their use in patients with coronavirus disease 2019 (COVID‐19). However, no studies have evaluated their use in patients with the COVID‐19 Delta variant. We aimed to study the performance of four different clinical scores (National Early Warning Score [NEWS], quick Sequential Organ Failure Assessment [qSOFA], Confusion, Respiratory rate, Blood pressure, and Age ≥65 [CRB‐65], and Kanagawa score) in predicting the risk of severe disease (defined as the need for intubation and in‐hospital mortality) in patients with the COVID‐19 Delta variant. Methods This was a retrospective cohort study of patients hospitalized with suspected severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Delta variant infection between June 1 and December 31, 2021. The primary outcomes were the sensitivity and specificity of the aforementioned clinical risk scores at admission to predict severe disease. Areas under the receiver operating characteristic curves (AUROCs) were compared between the clinical risk scores and we identified new cut‐off points for all four scores. Results A total of 249 adult patients were included, of whom 18 developed severe disease. A NEWS ≥7 at admission predicted severe disease with 72.2% sensitivity and 86.2% specificity. The NEWS (AUROC 0.88) was superior to both the qSOFA (AUROC 0.74) and the CRB‐65 (AUROC 0.67), and there was no significant difference between the NEWS and Kanagawa score (AUROC 0.86). Conclusion The NEWS at hospital admission predicted the severity of the COVID‐19 Delta variant with high accuracy.

Background: Extensive burns are associated with a high mortality rate. Early prediction and action can reduce mortality. The National Early Warning Score (NEWS) is considered the best early warning score for predicting mortality. However, there has been no assessment conducted on the clinical prognostic significance of NEWS in individuals suffering from severe burns. The objective of this research was to establish a nomogram based on burn characteristics and the NEWS to predict survival in severely burned patients., Methods: A retrospective analysis was performed on 335 patients diagnosed with extensive burns from 2005 to 2021 in the Department of Burn Surgery of Changhai Hospital, the First Affiliated Hospital of Naval Medical University. Univariate and multivariate analyses were used to determine independent prognostic factors. A nomogram was developed using these prognostic factors and its internal validity was assessed through bootstrap resampling., Results: The results of multivariate analysis showed that the independent factors affecting the prognosis of severe burn patients were age, full-thickness burn, creatinine, inhalation tracheotomy, and the NEWS, all of which were identified to create the nomogram. The Akaike Information Criterion and Bayesian Information Criterion values of the nomogram demonstrated superior goodness-of-fit in predicting severe burns compared to NEWS, with lower scores (195.21 vs. 201.24; 221.91 vs. 224.12, respectively). The bootstrap-adjusted concordance index (C-index) of the nomogram yielded a higher value of 0.923(95 % CI 0.892-0.953), compared to NEWS which had a C-index of 0.699 (95 % CI 0.628-0.770). The calibration curves demonstrated excellent agreement between predicted probabilities and observed outcomes in the nomogram analysis. Furthermore, decision curve analysis indicated promising clinical utility for the proposed nomogram model. By applying an appropriate cutoff value derived from receiver operating characteristics curve analysis, it was observed that the high-risk group identified by the nomogram exhibited a significantly higher mortality rate than the low-risk group., Conclusion: This study introduces an innovative nomogram that predicts the survival rate of individuals with severe burn injuries by combining clinical attributes and laboratory examinations, demonstrating superior efficacy compared to conventional NEWS systems., Competing Interests: Declaration of Competing Interest The authors affirm that there are no conflicts of interest. We confirm that we do not possess any financial or personal affiliations with individuals or organizations that could potentially exert undue influence on our work. Furthermore, we have no professional or personal interests whatsoever in any product, service, and/or company that may be perceived as impacting the stance presented in, or the evaluation of, this manuscript., (Copyright © 2024. Published by Elsevier Ltd.)

The medical emergency team enables the limitation of patients’ progression to critical illness in the general ward. The early warning scoring system (EWS) is one of the criteria for medical emergency team activation; however, it is not a valid criterion to predict the prognosis of patients with MET activation.

Introduction: The clinical diagnosis of COVID-19 is supplemented by clinical severity indices. These indices are the National Early Warning Score (NEWS, which aids in risk stratification), CT severity score (radiological severity score), and Reverse Transcription- Polymerase Chain Reaction (RT-PCR) cycle threshold (Ct value, which provides a semi-quantitative measure of viral load). Aim: To assess the correlation between NEWS at admission, RT-PCR Ct value and CT severity score in mild and moderate COVID-19 patients. Methods and Materials: This prospective cohort study was conducted in Maulana Azad Medical College and Lok Nayak hospital, New Delhi, from January to June 2021. The study included 50 subjects (25 with mild COVID-19 and 25 with moderate COVID-19). NEWS was calculated at admission and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Ct value was estimated using real-time RT-PCR. CT severity score was calculated based on High Resolution Computed Tomography (HRCT) chest findings. The correlation among the parameters was determined using Pearson correlation formula. Results: The mean age of subjects in the mild and moderate COVID-19 groups were 49.52 years and 51.84 years, respectively. The mean RT-PCR Ct value of E gene was 24.48 and Rdrp gene was 24.56 in the mild COVID-19 group; while in the moderate group it was 23.72 for both E gene and Rdrp genes. The correlation between NEWS and Ct value of E gene (r-value=-0.06, p-value=0.68), Ct value of Rdrp gene (r-value=- 0.03, p-value=0.79) and the correlation between CT severity score and Ct value of E gene (r-value=-0.05, p-value=0.73), Ct value of Rdrp gene (r-value=-0.06, p-value=0.68) was negative and insignificant. The mean CT severity score in mild COVID-19 group was 3.92, and in moderate COVID-19 group was 9.88. A significant positive correlation was found between the CT severity score and NEWS at admission. Conclusion: The clinical severity of COVID-19 as estimated by NEWS corroborates with CT severity score while the relationship between RT-PCR Ct value and clinicoradiological severity needs to be ascertained by further research. [ABSTRACT FROM AUTHOR]

Abstract Background The novel coronavirus SARS-19 produces ‘COVID-19’ in patients with symptoms. COVID-19 patients admitted to the hospital require early assessment and care including isolation. The National Early Warning Score (NEWS) and its updated version NEWS2 is a simple physiological scoring system used in hospitals, which may be useful in the early identification of COVID-19 patients. We investigate the performance of multiple enhanced NEWS2 models in predicting the risk of COVID-19. Methods Our cohort included unplanned adult medical admissions discharged over 3 months (11 March 2020 to 13 June 2020 ) from two hospitals (YH for model development; SH for external model validation). We used logistic regression to build multiple prediction models for the risk of COVID-19 using the first electronically recorded NEWS2 within ± 24 hours of admission. Model M0’ included NEWS2; model M1’ included NEWS2 + age + sex, and model M2’ extends model M1’ with subcomponents of NEWS2 (including diastolic blood pressure + oxygen flow rate + oxygen scale). Model performance was evaluated according to discrimination (c statistic), calibration (graphically), and clinical usefulness at NEWS2 ≥ 5. Results The prevalence of COVID-19 was higher in SH (11.0 %=277/2520) than YH (8.7 %=343/3924) with a higher first NEWS2 scores ( SH 3.2 vs YH 2.8) but similar in-hospital mortality (SH 8.4 % vs YH 8.2 %). The c-statistics for predicting the risk of COVID-19 for models M0’,M1’,M2’ in the development dataset were: M0’: 0.71 (95 %CI 0.68–0.74); M1’: 0.67 (95 %CI 0.64–0.70) and M2’: 0.78 (95 %CI 0.75–0.80)). For the validation datasets the c-statistics were: M0’ 0.65 (95 %CI 0.61–0.68); M1’: 0.67 (95 %CI 0.64–0.70) and M2’: 0.72 (95 %CI 0.69–0.75) ). The calibration slope was similar across all models but Model M2’ had the highest sensitivity (M0’ 44 % (95 %CI 38-50 %); M1’ 53 % (95 %CI 47-59 %) and M2’: 57 % (95 %CI 51-63 %)) and specificity (M0’ 75 % (95 %CI 73-77 %); M1’ 72 % (95 %CI 70-74 %) and M2’: 76 % (95 %CI 74-78 %)) for the validation dataset at NEWS2 ≥ 5. Conclusions Model M2’ appears to be reasonably accurate for predicting the risk of COVID-19. It may be clinically useful as an early warning system at the time of admission especially to triage large numbers of unplanned hospital admissions.

Lan Chen,1 Han Zheng,2 Lijun Chen,2 Sunying Wu,2 Saibin Wang3 1Nursing Education Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua Municipal Central Hospital, Jinhua, Zhejiang Province, People’s Republic of China; 2Emergency Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua Municipal Central Hospital, Jinhua, Zhejiang Province, People’s Republic of China; 3Department of Respiratory Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua Municipal Central Hospital, Jinhua, 321000, Zhejiang Province, People’s Republic of ChinaCorrespondence: Saibin WangDepartment of Respiratory Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua Municipal Central Hospital, No. 365, East Renmin Road, Jinhua, 321000, Zhejiang Province, People’s Republic of ChinaTel +86 579 82552278Fax +86 579 82325006Email saibinwang@hotmail.comBackground: For emergency triage, it is very important to identify patient severity according to their vital signs and chief complaint. Several studies have examined the predictive value of the National Early Warning Score (NEWS) for specific emergency patients and have shown it to be effective. However, few have studied the utility of NEWS in emergency triage for general emergency medicine patients. The aim of this research was to investigate the performance of NEWS in emergency triage with regard to predicting adverse outcomes.Methods: This was a retrospective cohort study carried out at a tertiary care center hospital in Jinhua, China. A total of 62,403 patients attending the emergency department (ED) from January to December 2018 were included. The NEWS, Modified Early Warning Score (MEWS), and quick Sepsis Related Organ Failure Assessment (qSOFA) score were obtained from emergency triage. Multivariate logistic regression analysis was performed to evaluate the associations between the NEWS, MEWS, and qSOFA, as well as those between other parameters with ED mortality. The predictive performances for emergency observation, death, and intensive care unit (ICU) admission of NEWS, MEWS and qSOFA were compared to the area under the receiver operating characteristic curve (AUROC).Results: Of the total participants, 6502 were placed under emergency observation, 106 died in the ED, 638 were admitted to the ICU, and 324 died in-hospital. The NEWS, qSOFA, age, and gender were significantly associated with ED mortality. NEWS was significantly better at discriminating all outcomes, and the area under the curve and 95% confidence intervals for ED mortality, observation in ED, composite of ED mortality and ICU admission, and in-hospital mortality were 0.862 (0.859– 0.865), 0.691 (0.687– 0.695), 0.859 (0.856– 0.861), and 0.805 (0.802– 0.808), respectively.Conclusion: NEWS shows good performance in discriminating critical emergency patients in ED triage for emergency medicine patients.Keywords: National Early Warning Score, triage, emergency department, predict, outcomes

Abstract Aims To explore Registered Nurses' experiences and perceptions with National Early Warning Score and Individual Early Warning Score to identify patient deterioration. Design A qualitative exploratory design. Methods Six focus groups were conducted at six Danish hospitals from February to June 2019. Registered Nurses from both medical, surgical and emergency departments participated. The focus groups were analysed using content analysis. Results One theme and four categories were identified. Theme: Meaningful in identifying patient deterioration but causing frustration due to lack of flexibility. Categories: (a) Inter‐professional collaboration strengthened through the use of Early Warning Score systems, (b) Enhanced professional development and communication among nurses when using Early Warning Score systems, (c) Detecting patient deterioration by integrating nurses' clinical gaze with Early Warning Score systems and (d) Modification and fear of making mistakes when using Early Warning Score systems.

• The frailty Index-laboratory (FI-lab) has been used as a simple assessment tool for frailty, but there is limited evidence about the use of FI-lab in the emergency care setting. • A higher FI-lab was associated with in-hospital death and prolonged length of hospital stay, similarly to the national early warning score and the modified JTAS, and was independently associated with the likelihood of discharge to home. • FI-lab can be used to evaluate the severity of illness, and was a useful indicator for predicting adverse outcomes in acute care. The emergency department is treating a growing number of older patients with frailty, which has been linked to poorer outcomes. Urgency is generally emphasized in the emergency department based on indicators such as triage scores and early warning scores for decision-making. However, this approach may not be sufficient for frail older people. The Frailty Index-laboratory (FI-lab) has been used as a simple assessment tool for frailty, but it may also reflect disease severity and predict adverse outcomes in the emergency care setting. Therefore, we aimed to evaluate the association between FI-lab in the emergency room and adverse outcomes during hospitalization through comparison with assessments using triage and early warning scores. This was a retrospective cohort study conducted in a tertiary hospital. The study included patients aged 65 years or older who were admitted to the general internal medicine ward after being initially evaluated in the emergency department. FI-lab was calculated using 24 laboratory parameters from blood tests. The National Early Warning Score (NEWS), the Japan Triage and Acuity Scale (JTAS), and the modified JTAS were also used as prognostic indicators, and their association with adverse outcomes was compared with that of FI-lab. In total, 872 patients (mean age, 80.9 years; male, 52.6 %) were analyzed. Patients who died during hospitalization had a higher FI-lab than those who survived. In multiple regression analysis, FI-lab, NEWS, and the modified JTAS were significantly associated with in-hospital death and prolonged length of hospital stay. In contrast, none of these indices were associated with in-hospital falls. The FI-lab was independently associated with the likelihood of discharge to home. FI-lab evaluated in the emergency department reflected the severity of illness in acutely hospitalized older adults, similarly to NEWS and JTAS, and was a useful indicator for predicting adverse outcomes. These results may indicate the value of FI-lab for older adults in the acute care setting. [ABSTRACT FROM AUTHOR]

Introduction: The clinical diagnosis of COVID-19 is supplemented by clinical severity indices. These indices are the National Early Warning Score (NEWS, which aids in risk stratification), CT severity score (radiological severity score), and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) cycle threshold (Ct value, which provides a semi-quantitative measure of viral load). Aim: To assess the correlation between NEWS at admission, RT-PCR Ct value and CT severity score in mild and moderate COVID-19 patients. Methods and Materials: This prospective cohort study was conducted in Maulana Azad Medical College and Lok Nayak hospital, New Delhi, from January to June 2021. The study included 50 subjects (25 with mild COVID-19 and 25 with moderate COVID-19). NEWS was calculated at admission and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Ct value was estimated using real-time RT-PCR. CT severity score was calculated based on High Resolution Computed Tomography (HRCT) chest findings. The correlation among the parameters was determined using Pearson correlation formula. Results: The mean age of subjects in the mild and moderate COVID-19 groups were 49.52 years and 51.84 years, respectively. The mean RT-PCR Ct value of E gene was 24.48 and Rdrp gene was 24.56 in the mild COVID-19 group; while in the moderate group it was 23.72 for both E gene and Rdrp genes. The correlation between NEWS and Ct value of E gene (r-value=-0.06, p-value=0.68), Ct value of Rdrp gene (r-value=-0.03, p-value=0.79) and the correlation between CT severity score and Ct value of E gene (r-value=-0.05, p-value=0.73), Ct value of Rdrp gene (r-value=-0.06, p-value=0.68) was negative and insignificant. The mean CT severity score in mild COVID-19 group was 3.92, and in moderate COVID-19 group was 9.88. A significant positive correlation was found between the CT severity score and NEWS at admission. Conclusion: The clinical severity of COVID-19 as estimated by NEWS corroborates with CT severity score while the relationship between RT-PCR Ct value and clinicoradiological severity needs to be ascertained by further research.

BackgroundModified Early Warning Score (MEWS) and National Early Warning Score (NEWS) are widely used in predicting the mortality and intensive care unit (ICU) admission of critically ill patients. This study was conducted to evaluate and compare the prognostic value of NEWS and MEWS for predicting ICU readmission, mortality, and related outcomes in critically ill patients at the time of ICU discharge.MethodsThis multicenter, prospective, observational study was conducted over a year, from April 2019 to March 2020, in the general ICUs of two university-affiliated hospitals in Northwest Iran. MEWS and NEWS were compared based on the patients’ outcomes (including mortality, ICU readmission, time to readmission, discharge type, mechanical ventilation (MV), MV duration, and multiple organ failure after readmission) using the univariable and multivariable binary logistic regression. The receiver operating characteristic (ROC) curve was used to determine the outcome predictability of MEWS and NEWS.ResultsA total of 410 ICU patients were enrolled in this study. According to multivariable logistic regression analysis, both MEWS and NEWS were predictors of ICU readmission, time to readmission, MV status after readmission, MV duration, and multiple organ failure after readmission. The area under the ROC curve (AUC) for predicting mortality was 0.91 (95% CI = 0.88–0.94, P < 0.0001) for the NEWS and 0.88 (95% CI = 0.84–0.91, P < 0.0001) for the MEWS. There was no significant difference between the AUC of the NEWS and the MEWS for predicting mortality (P = 0.082). However, for ICU readmission (0.84 vs. 0.71), time to readmission (0.82 vs. 0.67), MV after readmission (0.83 vs. 0.72), MV duration (0.81 vs. 0.67), and multiple organ failure (0.833 vs. 0.710), the AUCs of MEWS were significantly greater (P < 0.001).ConclusionNational Early Warning Score and MEWS values of >4 demonstrated high sensitivity and specificity in identifying the risk of mortality for the patients’ discharge from ICU. However, we found that the MEWS showed superiority over the NEWS score in predicting other outcomes. Eventually, MEWS could be considered an efficient prediction score for morbidity and mortality of critically ill patients.

Background: The vital‐sign monitoring strategy of patients with acute aortic dissection in the emergency department is mainly based on traditional experience. This study attempts to explore the significance of the national early warning score (NEWS) in monitoring the condition of patients with acute aortic dissection during emergency observation and to provide evidence for emergency nurses in optimal and scientific monitoring of patients. Methods: The case–control method was used to continuously enrol patients with acute aortic dissection who had been in the emergency department; the STROBE checklist was used in this process. Based on patients' clinical deterioration, they were divided into two groups: clinical deterioration and non‐clinical deterioration. The NEWS at each time point was compared by independent‐samples t‐test, and the predictive power of NEWS was evaluated according to the area under the receiver operating characteristic curve. Results: A total of 290 patients with acute aortic dissection were included: 46 patients showed clinical deterioration and 244 did not. There were significant differences in the NEW scores of the two groups at admission time and at 12, 8, 4 and 0.5 h before clinical deterioration. The NEW scores of the clinical deterioration group showed an upward trend, while the non‐clinical deterioration group showed a relatively stable trend. The NEWS can be used to predict the occurrence of clinical deterioration earlier at 4 h before clinical deterioration. Simultaneously, the patient's respiration rate and SpO2 had better predictive performance than other vital signs. Conclusion: The NEWS can be used to triage patients with acute aortic dissection admitted to the emergency department. Continuous use of the NEWS for monitoring can play a vital role in early warning of clinical deterioration in patients with acute aortic dissection. In clinical care, attention should also be paid when patients with acute aortic dissection have abnormal respiration rate and SpO2. [ABSTRACT FROM AUTHOR]

Background and Objectives: Physiological scoring systems could potentially aid emergency department (ED) trauma triage, and allowed clinicians to focus on treating the most severe patients first. This study aims to compare Modified Early Warning Score (MEWS), Worthing Physiological Scoring System (WPSS), National Early Warning Score (NEWS), and Rapid Emergency Medicine Score (REMS) in predicting inhospital mortality for multiple trauma patients. Methods: This prospective descriptive study was performed on adult multiple trauma patients referred to the ED of Al-Zahra and Kashani hospitals, Isfahan, Iran during 2019-2020. The primary outcome was inhospital mortality. Receiver operating characteristic (ROC) curve analysis was used to evaluate and compare the performances of four scores. Results: Of the 771 patients included in this study, 738 patients (95.7%) survived after 24 h of admission. The mean age of patients was 38.66 ± 18.67 years, and the majority of patients were male (79.1%). To predict inhospital mortality, the area under the ROC curve (AUC) of REMS, MEWS, NEWS, WPSS, and Injury Severity Score (ISS) were 0.944, 0.889, 0.768, 0.754, and 0.869, respectively. Results showed that REMS was more successful than other scores in predicting in-hospital mortality for multiple trauma patients. AUC of REMS was significantly better than NEWS, WPSS, and ISS in predicting inhospital mortality. Conclusions: The findings of this study reveal that REMS is an excellent predictor of in-hospital mortality and MEWS, NEWS, WPSS, and ISS are good predictors of in-hospital mortality.

Aim: To investigate whether trends in the NEWS values are associated with patient mortality in general ward patients. Methods: A one-year prospective observational study in three hospitals in Finland. All data on patients’ NEWS values during the first three days of general ward admissions were collected. The linear regression model was used to investigate the association of the NEWS trajectories with subsequent mortality. We used three outcome measures: 4–7-day, 4–14-day and 4–21-day mortality rates after the 0–3 days of initial hospitalization, respectively. Results: The study cohort consisted of 11,331 general ward patients. The non-survivors had higher initial NEWS score values in all outcome categories (all p

Aim:To examine changes in door-to-antibiotic time in pre- and post-intervention groups.Materials and Methods:A quasi-experimental study was conducted in the Emergency Department involving adult patients who were diagnosed with sepsis or septic shock in a university-based hospital. The patients were distributed into one of two groups: a pre-intervention or post-intervention group. In the post-intervention group, among patients with a suspected infection and a National Early Warning Score (NEWS) of ≥5, the sepsis fast track protocol was used in the normotensive group and the sepsis with shock fast track protocol was used in the hypotensive group. Our primary outcome was the difference in the door-to-antibiotic time in the pre- and post-intervention groups.Results:Overall, 117 patients were included in the pre-intervention group and 102 patients in the post-intervention group. The median door-to-antibiotic time in the pre-intervention group was 45 min [interquartile range (IQR): 30-65], and the median door-to-antibiotic time in the post-intervention group was 30 min (IQR: 20-55, p=0.009). However, there was no significant difference in the mortality rate (p=0.194).Conclusion:Using an activated system with NEWS for screening patients suspected with sepsis helped reduce the door-to-antibiotic time.

Abstract Background Failure to recognise and respond to patient deterioration on hospital wards is a common cause of healthcare-related harm. If patients are not rescued and suffer a cardiac arrest as a result then only around 15% will survive. Track and Trigger systems have been introduced into the NHS to improve both identification and response to such patients. This study examines the association between the type of Track & Trigger System (TTS) (National Early Warning Score (NEWS) versus non-NEWS) and the mode of TTS (paper TTS versus electronic TTS) and incidence of in-hospital ward-based cardiac arrests (IHCA) attended by a resuscitation team. Methods TTS type and mode was retrospectively collected at hospital level from 106 NHS acute hospitals in England between 2009 to 2015 via an organisational survey. Poisson regression and logistic regression models, adjusted for case-mix, temporal trends and seasonality were used to determine the association between TTS and hospital-level ward-based IHCA and survival rates. Results The NEWS was introduced in England in 2012 and by 2015, three-fifths of hospitals had adopted it. One fifth of hospitals had instituted an electronic TTS by 2015. Between 2009 and 2015 the incidence of IHCA fell. Introduction or use of NEWS in a hospital was associated with a reduction of 9.4% in the rate of ward-based IHCA compared to non-NEWS systems (incidence rate ratio 0.906, p

Objective The National Early Warning Score (NEWS), based on the patients’ vital signs, detects clinical deterioration in critically ill patients and is used to reduce the incidence of in-hospital cardiac arrest. However, although mortality prediction based on vital signs may be difficult in older patients, the effectiveness of the NEWS has not yet been evaluated in this population. This study aimed to test the hypothesis that an elevated NEWS at admission increases the mortality risk in older patients admitted to the emergency department (ED). Methods We conducted a single-center retrospective study, including patients admitted to the ED between November 2016 and February 2017. We included patients aged >65 years who were admitted to the ED for any medical problem. The NEWS was calculated at the time of ED admission. The primary outcome was in-hospital mortality. Results In total, 3,169 patients were included in this study. Median age was 75 years (interquartile range [IQR], 70 to 80 years), and 1,557 (49.1%) patients were male. The in-hospital mortality rate was 5.1% (161 patients). Median NEWS was higher in non-survivors than in survivors (5 [IQR, 3–8] vs. 1 [IQR, 0–3], P65 years.

Aim: Early identification of patients at risk of serious adverse events (SAEs) is of vital importance, yet it remains a challenging task. We investigated the predictive power of National Early Warning Score (NEWS) 2, as compared to NEWS, among patients assessed by a Rapid response team (RRT). Methods: Prospective, observational cohort study on 898 consecutive patients assessed by the RRTs in 26 Swedish hospitals. For each patient, NEWS and NEWS 2 scores were uniformly calculated by the study team. The associations of NEWS and NEWS 2 scores with unanticipated admissions to Intensive care unit (ICU), mortality and in-hospital cardiac arrests (IHCA) within 24 h, and the composite of these three events were investigated using logistic regression. The predictive power of NEWS and NEWS 2 was assessed using the area under the receiver operating characteristic (AUROC) curves. Results: The prognostic accuracy of NEWS/NEWS 2 in predicting mortality was acceptable (AUROC 0.69/0.67). In discriminating the composite outcome and unanticipated ICU admission, both NEWS and NEWS 2 were relatively weak (AUROC 0.62/0.62 and AUROC 0.59/0.60 respectively); for IHCA the performance was poor. There were no differences between NEWS and NEWS 2 as to the predictive power. Conclusion: The prognostic accuracy of NEWS 2 to predict mortality within 24 h was acceptable. However, the prognostic accuracy of NEWS 2 to predict IHCA was poor. NEWS and NEWS 2 performed similar in predicting the risk of SAEs but their performances were not sufficient for use as a risk stratification tool in patients assessed by a RRT.

Background: The National Early Warning Scores (NEWS) easily and objectively measures acute clinical deterioration. However, the performance of NEWS to predict mortality in patients with acute pulmonary embolism (APE) is still required. Therefore, the objective of this study was to evaluate the performance of the NEWS in predicting the mortality of patients with APE. Methods: NEWS and Pulmonary Embolism Severity Index (PESI) at diagnosis time were calculated. Risk regression analysis was performed to identify the NEWS and PESI risk classification as a predictor for 30 days all-cause mortality and PE-related mortality. Results: NEWS was significantly higher in non-survivors compared to survivors (median (IQR) was 10 (7, 11) vs. 7 (2, 9), respectively, p < 0.001). The best cut-off point of NEWS in discriminating APE patients who non-survived from those who survived at 30 days was ≥9, with a sensitivity and specificity of 66.9% and 66.3%, respectively. The adjusted risk ratio of 30-day all-cause mortality in patients with initial NEWS ≥ 9 was 2.96 (95% CI; 2.13, 4.12, p < 0.001). Conclusions: The NEWS can be used for mortality prediction in patients with APE. APE patients with NEWS ≥ 9 are associated with a high risk of mortality and should be closely monitored.

This study aimed to assess the predictive performance of the National Early Warning Score 2 (NEWS2) to identify the early progression to severe disease in patients with community-acquired pneumonia (CAP). A prospective-cohort study was conducted among patients with CAP admitted to a university hospital between October 2020 and December 2021. The endpoint of interest was the progression to severe CAP, defined as the requirement for a mechanical ventilator, a vasopressor, or death within 72 h after hospital admission. Among 260 patients, 53 (25.6%) had early progression to severe CAP. The median NEWS2 of the early progression group was higher than that of the non-progression group [8 (6–9) vs. 7 (5–8), p = 0.015, respectively]. The AUROC of NEWS2 to predict early progression to severe CAP was 0.61 (95% CI: 0.52–0.70), while IDSA/ATS minor criteria ≥ 3 had AUROC 0.56 (95% CI 0.48–0.65). The combination of NEWS2 ≥ 8, albumin level < 3 g/dL and BUN ≥ 30 mg/dL improved AUROC from 0.61 to 0.71 (p = 0.015). NEWS2 and IDSA/ATS minor criteria showed fair predictive-accuracy in predicting progression to severe CAP. The NEWS2 cut-off ≥ 8 in combination with low albumin and uremia improved predictive-accuracy, and could be easily used in general practice.

Objective: Copeptin, reflecting vasopressin release, as well as the National Early Warning Score (NEWS), reflecting the severity of critical illness, might qualify for survival prediction in elderly patients with critical illness. This prospective observational study aims at assessing the predictive value of copeptin combined with NEWS on the prognosis of elderly critical ill patients at emergency department (ED).Methods: We analyzed serum copeptin levels and the NEWS at admission to the ED in a prospective, single-center, and observational study comprising 205 elderly patients with critical illness. Death within 30 days after admission to the ED was the primary end point.Results: The serum copeptin levels and the NEWS in the non-survivor patients group were higher than those in the survivor group [30.35 (14.20, 38.91) vs 17.53 (13.01, 25.20), P = 0.001 and 9.0 (7.0-10.0) vs 7.0 (6.0-8.0), P = 0.001]. Multivariate logistic regression analysis showed that copeptin, NEWS and copeptin combined with NEWS were all independent risk factors for 30-day mortality in elderly patients with critical illness. Copeptin, NEWS and copeptin combined with NEWS all performed well in predicting 30-day survival, with area under the ROC curve (AUC) values of 0.766 (95%CI, 0.702-0.822), 0.797 (95%CI, 0.744-0.877) and 0.854 (95%CI, 0.798-0.899) respectively. Using the Z test to compare the areas under the above three curves, copeptin combined with NEWS showed a higher predictive value for 30-day survival (P < 0.05). As we calculated, the optimal cut-off values of copeptin and NEWS using the Youden index were 19.78 pg/mL and 8.5 points, respectively. Risk stratification analysis showed that patients with both copeptin levels higher than 19.78 pg/mL and NEWS points higher than 8.5 points had the highest risk of death.Conclusions: Copeptin combined with NEWS have a stronger predictive power on the prognosis of elderly patients with critical illness at ED, comparing to either factor individually. [ABSTRACT FROM AUTHOR]

Background: The prognostic value of the national early warning score (NEWS) in patients with infections remains controversial. We aimed to evaluate the prognostic accuracy of NEWS for prediction of in-hospital mortality in patients with infections outside the intensive care unit (ICU).Methods: We searched PubMed, Embase, and Scopus for related articles from January 2012 to April 2021. Sensitivity, specificity, and likelihood ratios were pooled by using the bivariate random-effects model. Overall prognostic performance was summarized by using the area under the curve (AUC). We performed subgroup analyses to assess the prognostic accuracy of NEWS in selected populations.Results: A total of 21 studies with 107,008 participants were included. The pooled sensitivity and specificity of NEWS were 0.71 and 0.60. The pooled AUC of NEWS was 0.70, which was similar to quick sequential organ failure assessment (qSOFA, AUC: 0.70) and better than systemic inflammatory response syndrome (SIRS, AUC: 0.60). However, the sensitivity (0.55) and AUC (0.63) of NEWS were poor in elder patients. The NEWS of 5 was more sensitive, which was a better threshold for activating urgent assessment and treatment.Conclusions: The NEWS had good diagnostic accuracy for early prediction of mortality in patients with infections outside the ICU, and the sensitivity and specificity were more moderate when compared with qSOFA and SIRS. Insufficient sensitivity and poor performance in the elder population may have limitations as an early warning score for adverse outcomes. NEWS should be used for continuous monitoring rather than a single time point predictive tool.

Background: The novel coronavirus SARS-19 produces 'COVID-19' in patients with symptoms. COVID-19 patients admitted to the hospital require early assessment and care including isolation. The National Early Warning Score (NEWS) and its updated version NEWS2 is a simple physiological scoring system used in hospitals, which may be useful in the early identification of COVID-19 patients. We investigate the performance of multiple enhanced NEWS2 models in predicting the risk of COVID-19.Methods: Our cohort included unplanned adult medical admissions discharged over 3 months (11 March 2020 to 13 June 2020 ) from two hospitals (YH for model development; SH for external model validation). We used logistic regression to build multiple prediction models for the risk of COVID-19 using the first electronically recorded NEWS2 within ± 24 hours of admission. Model M0' included NEWS2; model M1' included NEWS2 + age + sex, and model M2' extends model M1' with subcomponents of NEWS2 (including diastolic blood pressure + oxygen flow rate + oxygen scale). Model performance was evaluated according to discrimination (c statistic), calibration (graphically), and clinical usefulness at NEWS2 ≥ 5.Results: The prevalence of COVID-19 was higher in SH (11.0 %=277/2520) than YH (8.7 %=343/3924) with a higher first NEWS2 scores ( SH 3.2 vs YH 2.8) but similar in-hospital mortality (SH 8.4 % vs YH 8.2 %). The c-statistics for predicting the risk of COVID-19 for models M0',M1',M2' in the development dataset were: M0': 0.71 (95 %CI 0.68-0.74); M1': 0.67 (95 %CI 0.64-0.70) and M2': 0.78 (95 %CI 0.75-0.80)). For the validation datasets the c-statistics were: M0' 0.65 (95 %CI 0.61-0.68); M1': 0.67 (95 %CI 0.64-0.70) and M2': 0.72 (95 %CI 0.69-0.75) ). The calibration slope was similar across all models but Model M2' had the highest sensitivity (M0' 44 % (95 %CI 38-50 %); M1' 53 % (95 %CI 47-59 %) and M2': 57 % (95 %CI 51-63 %)) and specificity (M0' 75 % (95 %CI 73-77 %); M1' 72 % (95 %CI 70-74 %) and M2': 76 % (95 %CI 74-78 %)) for the validation dataset at NEWS2 ≥ 5.Conclusions: Model M2' appears to be reasonably accurate for predicting the risk of COVID-19. It may be clinically useful as an early warning system at the time of admission especially to triage large numbers of unplanned hospital admissions. [ABSTRACT FROM AUTHOR]

People in the UK are living longer and with multi-morbidities, increasing the size, complexity and acuity of Community Nursing caseloads. Nurses visiting infrequently and inconsistently on a task-focused basis need an objective method by which to identify / quantify physical deterioration for early treatment avoiding crisis and hospital admission. The National Early Warning Score (NEWS), is the most recognised tool for identification of deterioration in acute settings but is not validated for community use. Using published frameworks for scoping review and evaluation, this study aims to explore the current evidence for use of NEWS in community settings. Although there is work to be done, particularly in terms of frequency of scoring and response, this study identifies benefits in communication and prioritisation of care as well as sensitivity, particularly in predicting poor outcomes. The identified barriers to use include integration into practice and perceived dissonance with clinical judgement. [ABSTRACT FROM AUTHOR]

Aims: To explore Registered Nurses' experiences and perceptions with National Early Warning Score and Individual Early Warning Score to identify patient deterioration. Design: A qualitative exploratory design. Methods: Six focus groups were conducted at six Danish hospitals from February to June 2019. Registered Nurses from both medical, surgical and emergency departments participated. The focus groups were analysed using content analysis. Results: One theme and four categories were identified. Theme: Meaningful in identifying patient deterioration but causing frustration due to lack of flexibility. Categories: (a) Inter‐professional collaboration strengthened through the use of Early Warning Score systems, (b) Enhanced professional development and communication among nurses when using Early Warning Score systems, (c) Detecting patient deterioration by integrating nurses' clinical gaze with Early Warning Score systems and (d) Modification and fear of making mistakes when using Early Warning Score systems. [ABSTRACT FROM AUTHOR]

The National Early Warning Score scale correlates well with the intensity of the patient's acute condition. It could also correlate with the nursing activity load and prove useful in defining and redistributing nursing resources based on the acuity of patients. To assess whether patients' National Early Warning Score at hospital admission correlates with objective nursing demands and can be used to optimize the distribution of available care resources. This single-center prospective study included patients admitted to the Department of Internal Medicine at the Civil Hospital in Altovicentino (Italy) between September 1 and December 31, 2022. Nursing activities were recorded for the first three days after admission and standardized to the daily mean as performance/5 min/patient/day. Linear regression was used to assess the correlation between nursing demands for different National Early Warning Scores. This study included 333 patients. Their mean National Early Warning Score was 3.9 (standard deviation: 2.9), with 61 % (203/333) in the National Early Warning Score < 5 category, 19.5 % (65/333) in the National Early Warning Score 5–6 category, and 19.5 % (65/333) in the National Early Warning Score > 6 category. Their average daily care requirements increased from 22 (16–30) activities/5 min/patient/day in the low National Early Warning Score category to 30 (20–39) activities/5 min/patient/day in the intermediate National Early Warning Score category (p < 0.001) and 35 (23–45) activities/5 min/patient/day in the high National Early Warning Score category (p < 0.001). The National Early Warning Score correlates with nursing care activities for patients with an acute condition and can be used to optimize the distribution of available care resources. [ABSTRACT FROM AUTHOR]

Abstract Background The national early warning score (NEWS) enables early detection of in-hospital patient deterioration and timely activation of hospital’s rapid response team (RRT). NEWS was updated in 2017 to include a separate SpO2 scale for those patients with type II respiratory failure (T2RF). In this study we investigated whether NEWS with and without the new SpO2 scale for the T2RF patients is associated with immediate and in-hospital patient outcomes among the patients actually attended by the RRT. Methods We conducted a two-year prospective observational study including all adult RRT patients without limitations of medical treatment (LOMT) in a large Finnish university associated tertiary level hospital. According to the first vital signs measured by the RRT, we calculated NEWSs for the RRT patients and further utilized the new SpO2 scale for the patients with confirmed T2RF. We used multivariate logistic regression and area under the receiver operating characteristic analyses to test NEWS’s accuracy to predict two distinct outcomes: RRT patient’s I) immediate need for intensive care and/or new LOMT and 2) in-hospital death or discharge with cerebral performance category >2 and/or LOMT. Results The final cohort consisted of 886 RRT patients attended for the first time during their hospitalization. Most common reasons for RRT activation were respiratory (343, 39%) and circulatory (226, 26%) problems. Cohort’s median (Q1, Q3) NEWS at RRT arrival was 8 (5, 10) and remained unchanged if the new SpO2 scale was applied for the 104 patients with confirmed T2RF. Higher NEWS was independently associated with both immediate (OR 1.28; 95% CI 1.22–1.35) and in-hospital (1.15; 1.10–1.21) adverse outcomes. Further, NEWS had fair discrimination for both the immediate (AUROC 0.73; 0.69–0.77) and in-hospital (0.68; 0.64–0.72) outcomes. Utilizing the new SpO2 scale for the patients with confirmed T2RF did not improve the discrimination capability (0.73; 0.69–0.76 and 0.68; 0.64–0.71) for these outcomes, respectively. Conclusions We found that in patients attended by a RRT, the NEWS predicts patient’s hospital outcome with moderate accuracy. We did not find any improvement using the new SpO2 scale in T2RF patients.

Abstract Background The National Early Warning Score (NEWS/NEWS 2) has been adopted across the National Health Service (NHS) in the U.K. as a method of escalating care for deteriorating patients. Intensive Care Unit (ICU) resources are limited and in high demand, with patient discharge a focal point for managing resources effectively. There are currently no universally accepted methods for assessing discharge of patients from an ICU, which can cause premature discharges and put patients at risk of subsequent deterioration, readmission to ICU or death. Methods We tested the ability of the NEWS to discriminate patients within 24h of admission to an ICU in a U.S. hospital during 2001–2012, by their end discharge location: home; hospital ward; nursing facility; hospice and death. The NEWS performance was compared across five different ICU specialties, using the area under the receiver operating characteristic (AUROC) curve and a large vital signs database (n=2,723,055) collected from 28,523 critical care admissions. Results The NEWS AUROC (95% CI) at 24h following admission: all patients 0.727 (0.709–0.745); Coronary Care Unit (CCU) 0.829 (0.821–0.837); Cardiac Surgery Recovery Unit (CSRU) 0.844 (0.838–0.850); Medical Intensive Care Unit (MICU) 0.778 (0.767–0.791); Surgical Intensive Care Unit (SICU) 0.775 (0.762–0.788); Trauma Surgical Intensive Care Unit (TSICU) 0.765 (0.751–0.773). Conclusions The NEWS has reasonable discrimination for any ICU patient’s discharge location. The NEWS has greater ability to discriminate patients in the Coronary Care Unit (CCU) and Cardiac Surgery Recovery Unit (CSRU) compared to other ICU specialties. The NEWS has the real potential to be applied within a universal discharge planning tool for ICU, improving patient safety at the point of discharge.

Aim Although rapid response systems (RRS) are used to prevent adverse events, Japan reportedly has low activation rates and high mortality rates. The National Early Warning Score (NEWS) could provide a solution, but it has not been validated in Japan. We aimed to validate NEWS for Japanese patients. Methods This retrospective observational study included data of 2,255 adult patients from 33 facilities registered in the In‐Hospital Emergency Registry in Japan between January 2014 and March 2018. The primary evaluated outcome was mortality rate 30 days after RRS activation. Accuracy of NEWS was analyzed with the correlation coefficient and area under the receiver operating characteristic curve. Prediction weights of NEWS parameters were then analyzed using multiple logistic regression and a machine learning method, classification and regression trees. Results The correlation coefficient of NEWS for 30‐day mortality rate was 0.95 (95% confidence interval [CI], 0.88–0.98) and the area under the receiver operating characteristic curve was 0.668 (95% CI, 0.642–0.693). Sensitivity and specificity values with a cut‐off score of 7 were 89.8% and 45.1%, respectively. Regarding prediction values of each parameter, oxygen saturation showed the highest odds ratio of 1.36 (95% CI, 1.25–1.48), followed by altered mental status 1.23 (95% CI, 1.14–1.32), heart rate 1.21 (95% CI, 1.09–1.34), systolic blood pressure 1.12 (95% CI, 1.04–1.22), and respiratory rate 1.03 (95% CI, 1.05–1.26). Body temperature and oxygen supplementation were not significantly associated. Classification and regression trees showed oxygen saturation as the most heavily weighted parameter, followed by altered mental status and respiratory rate. Conclusions National Early Warning Score could stratify 30‐day mortality risk following RRS activation in Japanese patients.

This work aimed to investigate the adoption value of blood lactic acid (BLA) combined with the National Early Warning Score (NEWS) in the early screening of sepsis patients and assessing their severity. The data and materials utilized in this work were obtained from the electronic medical record system of 537 anonymized sepsis patients who received emergency rescue in the emergency rescue area of Liuzhou People's Hospital, Guangxi, from July 1, 2020, to December 26, 2020. Based on the 28-day outcomes of sepsis patients, the medical records were rolled into Group S (407 survival cases) and Group D (130 dead cases). Basic information such as the mode of hospital admission, initial management, use of emergency ventilator within 24 h of admission, NEWS score, arterial oxygen pressure/alveolar oxygen pressure ratio (PaO 2 /PAO 2 ), alveolar-arterial oxygen difference (A-aDO 2 ), serum creatinine (SCr), blood urea nitrogen (BUN), oxygenation index (OI), Glasgow Coma Scale (GCS), D-dimer, use of vasoactive drugs within 24 h of admission, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), N-terminal pro-B-type natriuretic peptide (NT-proBNP), quick Sequential Organ Failure Assessment (qSOFA) score, SOFA score, BLA level, NEWS with lactate (NEWS-L) score, SOFA score including lactate level (SOFA-L) score, Intensive Care Unit (ICU) length of stay, total hospital stay, ICU stay/total hospital stay, and septic shock condition were compared between groups. Logistic regression analysis was performed to assess the impact of various predictive factors on prognosis and to plot the receiver operating characteristic (ROC) curve. The results suggested marked differences between Group S and Group D in terms of mean age ( t  = -5.620; OR = -9.96, 95 % CI: -13.44∼-6.47; P  < 0.001). Group S showed drastic differences in terms of mode of hospital admission (χ 2  = 9.618, P  < 0.01), method of initial management (χ 2  = 51.766, P  < 0.001), use of emergency ventilator within 24 h of admission (χ 2  = 98.564, P  < 0.001), incidence of septic shock (χ 2  = 77.545, P  < 0.001), use of vasoactive drugs within 24 h of admission (χ 2  = 102.453, P  < 0.001), heart rate ( t  = -4.063, P  < 0.001), respiratory rate ( t  = -4.758, P  < 0.001), oxygenation status (χ 2  = 20.547, P  < 0.001), NEWS score ( t  = -6.120, P  < 0.001), PaO 2 /PAO 2 ratio ( t  = 2.625, P  < 0.01), A-aDO 2 value ( Z  = -3.581, P  < 0.001), OI value ( Z  = -3.106, P  < 0.01), PLT value ( Z  = -2.305, P  < 0.05), SCr value ( Z  = -3.510, P  < 0.001), BUN value ( Z  = -3.170, P  < 0.01), D-dimer ( Z  = -4.621, P  < 0.001), CRP level ( Z  = -4.057, P  < 0.001), PCT value ( Z  = -2.783, P  < 0.01), IL-6 level ( Z  = -2.904, P  < 0.001), length of hospital stay ( Z  = -4.138, P  < 0.001), total hospital stay ( Z  = -8.488, P  < 0.001), CCU/total hospital stay ( Z  = -9.118, P  < 0.001), NEWS score ( t  = -6.120, P  < 0.001), SOFA score ( t  = -6.961, P  < 0.001), SOFA-L score ( Z  = -4.609, P  < 0.001), NEWS-L score ( Z  = -5.845, P  < 0.001), BLA level ( Z  = -6.557, P  < 0.001), and GCS score ( Z  = 6.909, P  < 0.001) when compared to Group D. The use of ventilators, septic shock, PCT, NEWS score, GCS score, SOFA score, SOFA-L score, NEWS-L score, and BLA level were identified as independent risk factors for predicting the prognosis of sepsis patients ( P  < 0.001). The areas under ROC curve (AUC) of blood lactic acid, PCT, NEWS, NEWS-L, GCS, SOFA, and SOFA-L were 0.695, 0.665, 0.692, 0.698, 0.477, 0.700, and 0.653, respectively. These findings indicate that the combination of BLA with NEWS (NEWS-L) score and SOFA score has certain advantages in assessing the prognosis of sepsis., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)