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

Suh, Ja Hyoen; Kim, Dong Hoon; Kang, Changwoo; Lee, Soo Hoon; Jeong, Jin Hee; Kim, Taeyun; Lee, Sang Bong; Kim, Seong Chun

J Korean Soc Emerg Med > Volume 30(6); 2019 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2019;30(6): 563-568.

National Early Warning Score를 손상 환자에게도 사용할 수 있는가?

서자현¹, 김동훈^1,2

, 강창우^1,2, 이수훈^1,2, 정진희^1,2, 김태윤^1,2, 이상봉^1,2, 김성춘^2,3

¹경상대학교 의학전문대학원 응급의학교실
²경상대학교 건강과학연구원
³창원경상대학교병원 응급의학과

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

Ja Hyoen Suh¹, Dong Hoon Kim^1,2

, Changwoo Kang^1,2, Soo Hoon Lee^1,2, Jin Hee Jeong^1,2, Taeyun Kim^1,2, Sang Bong Lee^1,2, Seong Chun Kim^2,3

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