Key result
The National Early Warning Score (NEWS) at transfer from the ICU predicted clinical deterioration and readmission to the ICU (OR 1.32; 95% CI 1.01-1.72; P=0.04).
Why the study?
Patients transferred from an intensive care unit to a general ward are at risk for clinical deterioration, prompting an investigation into whether increasing NEWS values predict worse outcomes.
Does an increase in National Early Warning Score (NEWS) predict clinical deterioration in gastrointestinal surgery patients transferred from ICU to a general ward?
Observational (n=124)
Does an increase in National Early Warning Score (NEWS) predict clinical deterioration in gastrointestinal surgery patients transferred from ICU to a general ward?
Odds Ratio: 1.32 (95% CI 1.01–1.72)
p-value: p=0.04
An increase in the National Early Warning Score (NEWS) precedes and predicts clinical deterioration and ICU readmission in post-ICU gastrointestinal surgery patients.
May flag higher ICU readmission risk after ward transfer; hypothesis-generating and requires prospective validation before guiding practice.
Purpose: Patients transferred from an intensive care unit (ICU) to a general ward are at risk for clinical deterioration. The aim of the study was to determine if an increase in National Early Warning Score (NEWS) value predicted worse outcomes in surgical ward patients previously treated in the ICU. Patients and methods: A retrospective observational study was conducted in a cohort of gastrointestinal surgery patients after transfer from an ICU/high dependency unit (HDU). NEWS values were collected throughout the ward admission. Clinical deterioration was defined by ICU readmission or death. The ability of NEWS to predict clinical deterioration was determined using a linear mixed effect model. Results: We included 124 patients, age 65.9±14.5, 60% males with an ICU Simplified Acute Physiology Score II 33.8±12.7. No patients died unexpectedly at the ward and 20 were readmitted to an ICU/HDU. The NEWS values increased by a mean of 0.15 points per hour (intercept 3.7, P <0.001) before ICU/HDU readmission according to the linear mixed effect model. NEWS at transfer from ICU was the only factor that predicted readmission (OR 1.32; 95% CI 1.01–1.72; P =0.04) at the time of admission to the ward. Conclusion: Clinical deterioration of surgical patients was preceded by an increase in NEWS.
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Klepstad et al. (2019) conducted an observational in Post-ICU gastrointestinal surgery patients (n=124). National Early Warning Score (NEWS) was evaluated on Clinical deterioration (ICU readmission or death) (OR 1.32, 95% CI 1.01-1.72, p=0.04). The National Early Warning Score (NEWS) at transfer from the ICU predicted clinical deterioration and readmission to the ICU (OR 1.32; 95% CI 1.01-1.72; P=0.04).
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