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J Korean Soc Emerg Med > Volume 30(6); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(6): 563-568.
National Early Warning Score를 손상 환자에게도 사용할 수 있는가?
서자현1, 김동훈1,2 , 강창우1,2, 이수훈1,2, 정진희1,2, 김태윤1,2, 이상봉1,2, 김성춘2,3
1경상대학교 의학전문대학원 응급의학교실
2경상대학교 건강과학연구원
3창원경상대학교병원 응급의학과
Is the National Early Warning Score applicable to patients with trauma?
Ja Hyoen Suh1, Dong Hoon Kim1,2 , Changwoo Kang1,2, Soo Hoon Lee1,2, Jin Hee Jeong1,2, Taeyun Kim1,2, Sang Bong Lee1,2, Seong Chun Kim2,3
1Department of Emergency Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
2Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
3Department of Emergency Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
Correspondence  Dong Hoon Kim ,Tel: 055-750-8216, Fax: 055-757-0514, Email: kloud144@gmail.com,
Received: June 19, 2019; Revised: September 2, 2019   Accepted: September 4, 2019.  Published online: December 31, 2019.
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.
Method:
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.
Key words: Mortality; National Early Warning Score; Revised Trauma Score; Emergency department
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