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The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia

Authors :
Pattraporn Tajarernmuang
Pimchanok Sanwirat
Juthamas Inchai
Phichayut Phinyo
Atikun Limsukon
Source :
Tropical Medicine and Infectious Disease, Vol 8, Iss 2, p 68 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

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.

Details

Language :
English
ISSN :
24146366
Volume :
8
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Tropical Medicine and Infectious Disease
Publication Type :
Academic Journal
Accession number :
edsdoj.66d1ee3eae1407e8f92e6c79bacf442
Document Type :
article
Full Text :
https://doi.org/10.3390/tropicalmed8020068