Does the prehospital National Early Warning Score predict the short-term mortality of unselected emergency patients?

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http://hdl.handle.net/10138/236579

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Hoikka , M , Silfvast , T & Ala-Kokko , T I 2018 , ' Does the prehospital National Early Warning Score predict the short-term mortality of unselected emergency patients? ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 26 , 48 . https://doi.org/10.1186/s13049-018-0514-1

Title: Does the prehospital National Early Warning Score predict the short-term mortality of unselected emergency patients?
Author: Hoikka, Marko; Silfvast, Tom; Ala-Kokko, Tero I.
Contributor: University of Helsinki, Clinicum
Date: 2018-06-07
Language: eng
Number of pages: 7
Belongs to series: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
ISSN: 1757-7241
URI: http://hdl.handle.net/10138/236579
Abstract: Objectives: The prehospital research field has focused on studying patient survival in cardiac arrest, as well as acute coronary syndrome, stroke, and trauma. There is little known about the overall short-term mortality and its predictability in unselected prehospital patients. This study examines whether a prehospital National Early Warning Score (NEWS) predicts 1-day and 30-day mortalities. Methods: Data from all emergency medical service (EMS) situations were coupled to the mortality data obtained from the Causes of Death Registry during a six-month period in Northern Finland. NEWS values were calculated from first clinical parameters obtained on the scene and patients were categorized to the low, medium and high-risk groups accordingly. Sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs), and likelihood ratios (PLRs and NLRs) were calculated for 1-day and 30-day mortalities at the cut-off risks. Results: A total of 12,426 EMS calls were included in the study. The overall 1-day and 30-day mortalities were 1.5 and 4.3%, respectively. The 1-day mortality rate for NEWS values = 13 higher than 20%. The high-risk NEWS group had sensitivities for 1-day and 30-day mortalities 0.801 (CI 0.74-0.86) and 0.42 (CI 0.38-0.47), respectively. Conclusion: In prehospital environment, the high risk NEWS category was associated with 1-day mortality well above that of the medium and low risk NEWS categories. This effect was not as noticeable for 30-day mortality. The prehospital NEWS may be useful tool for recognising patients at early risk of death, allowing earlier interventions and responds to these patients.
Subject: Emergency medical services
Early warning score
Triage
CARDIAC-ARREST
SURVIVAL
ABILITY
3126 Surgery, anesthesiology, intensive care, radiology
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