ArticleClinical medicine (London, England)2019
The inclusion of delirium in version 2 of the National Early Warning Score will substantially increase the alerts for escalating levels of care: findings from a retrospective database study of emergency medical admissions in two hospitals .
Article in Clinical medicine (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- One Score Fits All? A Narrative Review on Early Warning Scores for Older Adults in the Emergency Department in the Era of Personalized Medicine.Journal of personalized medicine · 2026Review
- Impact of Living Arrangements on Delirium in Older ED Patients.Journal of clinical medicine · 2025Article
- The United Kingdom's National Early Warning Score: should everyone use it? A narrative review.Internal and emergency medicine · 2023Review
- NEWS2 shows low sensitivity and high specificity for delirium detection: a single site observational study of 13,908 patients.Clinical medicine (London, England) · 2022Observational
- The National Early Warning Score 2 (NEWS2) - Elderly patients and training of nursing / allied healthcare professionals in using NEWS2.Clinical medicine (London, England) · 2019Article
- The National Early Warning Score and the acutely confused patient.Clinical medicine (London, England) · 2019Article
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Abstract
backgroundThe National Early Warning Score (NEWS) is being replaced with NEWS2 which adds 3 points for new confusion or delirium. We estimated the impact of adding delirium on the number of medium/high level alerts that are triggers to escalate care.
methodsAnalysis of emergency medical admissions in two acute hospitals (York Hospital (YH) and Northern Lincolnshire and Goole NHS Foundation Trust hospitals (NH)) in England. Twenty per cent were randomly assigned to have delirium.
resultsThe number of emergency admissions (YH: 35584; NH: 35795), mortality (YH: 5.7%; NH: 5.5%), index NEWS (YH: 2.5; NH: 2.1) and numbers of NEWS recorded (YH: 879193; NH: 884072) were similar in each hospital. The mean number of patients with medium level alerts per day increased from 55.3 (NEWS) to 69.5 (NEWS2), a 25.7% increase in YH and 64.1 (NEWS) to 77.4 (NEWS2), a 20.7% increase in NH. The mean number of patients with high level alerts per day increased from 27.3 (NEWS) to 34.4 (NEWS2), a 26.0% increase in YH and 29.9 (NEWS) to 37.7 (NEWS2), a 26.1% increase in NH.
conclusionsThe addition of delirium in NEWS2 will have a substantial increase in medium and high level alerts in hospitalised emergency medical patients. Rigorous evaluation of NEWS2 is required before widespread implementation because the extent to which staff can cope with this increase without adverse consequences remains unknown.
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