The National Early Warning Score 2 (NEWS2) predicted early mortality in prehospital and emergency settings with an estimate of 0.78 (95% CI 0.74-0.82), but performed poorly for 30-day and in-hospital mortality.
Meta-Analysis
Does the National Early Warning Score 2 (NEWS2) accurately predict early mortality in patients in prehospital settings and emergency departments?
NEWS2 has excellent sensitivity and specificity in predicting early mortality in prehospital and emergency settings, but poor performance for in-hospital and 30-day mortality.
Effect estimate: 0.78 (95% CI 0.74, 0.82)
Background: Many studies have explored the accuracy of the National Early Warning Score 2 (NEWS2) in predicting mortality in prehospital and emergency settings, but their findings are inconsistent. Whether NEWS2 is reliable for the pre-examination and triage of patients in prehospital settings and emergency departments remains debatable. Hence, this study aimed to evaluate the accuracy of NEWS2 in predicting mortality in prehospital settings and emergency departments. Methods: We searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wan Fang Data, Vip Database and SinoMed from the inception of each database to January 2023. The inclusion criteria: (I) patients in the prehospital settings or emergency departments; (II) the NEWS2 for predicting 2-day mortality, 30-day mortality, and in-hospital mortality; (III) sufficient data, such as sensitivity, specificity, overall survival, and deaths, were provided for the study; (IV) the type of study was accuracy prediction study. Two authors independently extracted data, including authors, year of publication, country of origin, study design, sample size, threshold cutoff values of NEWS2, and mortality. The PROBAST was used to assess the risk of bias in the included studies. Results: 0.78 (95% CI: 0.74, 0.82), respectively. Conclusions: NEWS2 has excellent sensitivity and specificity in predicting early mortality in patients in the prehospitals setting and emergency departments. Nonetheless, it has poor performance in predicting in-hospital mortality and 30-day mortality. Our findings underpin the use of NEWS2 as a pre-examination and triage tool to predict early death in the prehospital settings and emergency departments. To improve the predictive accuracy, it should be used to monitor patients continuously rather than at a single point-in-time.
Wei et al. (2023) conducted a meta-analysis in Prehospital and emergency department patients. National Early Warning Score 2 (NEWS2) was evaluated on 2-day mortality, 30-day mortality, and in-hospital mortality (0.78, 95% CI 0.74, 0.82). The National Early Warning Score 2 (NEWS2) predicted early mortality in prehospital and emergency settings with an estimate of 0.78 (95% CI 0.74-0.82), but performed poorly for 30-day and in-hospital mortality.