ArticleBMJ open respiratory research2024
Real-world implementation of the National Early Warning Score-2 in an acute respiratory unit.
Article in BMJ open respiratory research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed.
- Exploring modifications to rapid response systems in Norwegian hospital units.Implementation science communications · 2025Article
- Prognostic Value of Inflammatory and Metabolic Biomarkers in ICU-Admitted Trauma Patients: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- A single early warning signs (SEWS) system for recognizing clinically deterioration outperforms the national early warning score (NEWS) by having a lower activation threshold, broader clinical scope, and faster response time.Resuscitation plus · 2025Article
- Physiological deterioration prior to in-hospital cardiac arrest: What does the National Early Warning Score-2 miss?Resuscitation plus · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
introductionThe National Early Warning Score-2 (NEWS-2) is used to detect deteriorating patients in hospital settings. We aimed to understand how NEWS-2 functions in the real-life setting of an acute respiratory unit.
methodsClinical observations data were extracted for adult patients (age ≥18 years), admitted under the care of respiratory medicine services from July to December 2019, who had at least one recorded task relating to clinical deterioration. The timing and nature of urgent out-of-hours medical reviews (escalations) were extracted through manual review of the case notes.
resultsThe data set comprised 765 admission episodes (48.9% women) with a mean (SD) age of 69.3 (14.8). 8971 out of 35 991 out-of-hours observation sets (24.9%) had a NEWS-2 ≥5, and 586 of these (6.5%) led to an escalation. Out of 687 escalations, 101 (14.7%) were associated with observation sets with NEWS-2<5. Rising oxygen requirement and extreme values of individual observations were associated with an increased risk of escalation. 57.6% of escalations resulted in a change in treatment. Inpatient mortality was higher in patients who were escalated at least once, compared with those who were not escalated.
conclusionsMost observation sets with NEWS-2 scores ≥5 did not lead to a medical escalation in an acute respiratory setting out-of-hours, but more than half of escalations resulted in a change in treatment. Rising oxygen requirement is a key indicator of respiratory patient acuity which appears to influence the decision to request urgent out-of-hours medical reviews.
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