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J Korean Soc Emerg Med > Volume 34(1); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(1): 10-19.
병원간 전원을 시행한 중증환자에서 National Early Warning Score 변화가 예후에 미치는 영향
정화윤1 , 박정호1,2 , 김기홍1,2 , 이선영2,3 , 노영선1,2 , 송경준2,4 , 신상도1,2
1서울대학교병원 응급의학과
2서울대학교병원 의생명연구원 응급의료연구실
3서울대학교병원 공공진료센터
4서울특별시 보라매병원 응급의학과
Changes and their prognostic implications of the National Early Warning Score (NEWS) in interhospital transferred critically ill patients
Hwayoon Jung1 , Jeong Ho Park1,2 , Ki Hong Kim1,2 , Sun Young Lee2,3 , Young Sun Ro1,2 , Kyoung Jun Song2,4 , Sang Do Shin1,2
1Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
2Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital Seoul, Korea
3Comprehensive Community Care Center, Seoul National University Hospital, Seoul, Korea
4Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
Correspondence  Jeong Ho Park ,Tel: 02-2072-1800, Fax: 02-741-7855, Email: timthe@gmail.com,
Received: March 25, 2022; Revised: August 13, 2022   Accepted: October 9, 2022.  Published online: February 28, 2023.
This study aimed to investigate the association between the change in the National Early Warning Score (NEWS) before and after interhospital transport and the survival of critically ill patients transported by critical care transport.
A retrospective analysis of SMICU (Seoul Mobile Intensive Care Unit) transfer records and the National Emergency Department Information System (NEDIS) was conducted. Adult patients who used SMICU from 2016 to 2018 were included. Trauma patients and post-cardiac arrest patients were excluded. The NEWS before departure from the transferring hospital and the NEWS before the arrival at the receiving hospital were extracted, and the difference between both NEWS (△ NEWS) was calculated. The △ NEWS was categorized into three groups: -2 or less, -1 to 1, and 2 or more. The primary outcome was 24-hour post-transport mortality. Multivariable logistic regression was applied to calculate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for the outcomes.
Of the total number of 1,837 patients, 1,065 patients were included. △ NEWS were -2 or less in 131 (12.3%), -1 to 1 in 805 (75.6%), and 2 or more in 129 (12.1%) of the patients. The 24-hour mortality rate was 3.1%, 2.9%, and 7.0% in the △ NEWS≤-2, -1≤△ NEWS≤1, and △ NEWS≥2 groups, respectively. Relative to -1≤△ NEWS≤1, the AORs for the 24-hour mortality were 1.11 (95% CI, 0.38-3.29) in △ NEWS≤-2 and 2.56 (95% CI, 1.15-5.70) in △ NEWS≥2.
The changes in NEWS in critical care interhospital transport are associated with patient prognosis.
Key words: Early Warning Scores; Critical illness; Patient transfer; mortality
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