Key result
The National Early Warning Score (NEWS) correlated positively with illness severity (r=0.605, P<0.001) and outperformed the Modified Early Warning Score in detecting severity (P<0.05).
Why the study?
Population aging is an increasing concern, prompting the need to evaluate whether the National Early Warning Score can provide early detection of illness severity changes in elderly patients hospitalized in a gastrointestinal surgical department.
Does the National Early Warning Score (NEWS) accurately assess postoperative illness severity in elderly patients with gastrointestinal illnesses compared to MEWS?
Observational (n=528)
No
Does the National Early Warning Score (NEWS) accurately assess postoperative illness severity in elderly patients with gastrointestinal illnesses compared to MEWS?
Effect estimate: r=0.605
p-value: p=<0.001
NEWS is an effective tool for early detection of illness severity changes in elderly patients hospitalized for gastrointestinal surgery, outperforming MEWS.
NEWS may aid severity assessment; leaves open prospective validation before clinical adoption.
BACKGROUND: Population aging is a social problem that is being faced in most countries. OBJECTIVE: To apply the National Early Warning Score (NEWS) for an early warning on the vital signs and consciousness of elderly patients who are hospitalized in the gastrointestinal surgical department and to provide a reference for early detection of changes in illness severity in elderly patients by studying the correlation between NEWS value and changes in illness severity. METHODS: We enrolled 528 elderly patients who were hospitalized in the gastrointestinal surgical department of a tertiary grade A hospital in Guizhou Province between June 2020 and May 2021, to analyze how NEWS max value correlates with illness severity and obtain the optimal NEWS cutoff value for both potentially critically ill and critically ill elderly patients using the receiver operating characteristic (ROC) curve. RESULTS: There were statistically significant differences in NEWS values between elderly patients with various illness severities (P< 0.05). NEWS values correlated positively with illness severity (r= 0.605, P< 0.001). Based on the ROC curve, early warning trigger values for NEWS to identify potentially critically ill, critically ill and terminally ill elderly patients were 6, 7 and 8, respectively. The area under the curve (AUC) for potentially critically ill, critically ill and terminally ill elderly patients was 0.907, 0.921 and 0.939, respectively. NEWS performed better in detecting patient illness severity than Modified Early Warning Score (MEWS) in AUC, sensitivity, specificity, and Youden's index, with statistically significant differences (P< 0.05). CONCLUSION: An early warning on the vital signs and consciousness of hospitalized elderly patients using NEWS can facilitate advanced detection of changes in illness severity of elderly patients by medical staff and enable timely treatment, thus significantly lowering the risks of illness deterioration.
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Li et al. (2023) conducted an observational in Gastrointestinal illnesses (n=528). National Early Warning Score (NEWS) vs. Modified Early Warning Score (MEWS) was evaluated on Detection of patient illness severity (r=0.605, p=<0.001). The National Early Warning Score (NEWS) correlated positively with illness severity (r=0.605, P<0.001) and outperformed the Modified Early Warning Score in detecting severity (P<0.05).
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