Evidence map›Paper›PMID 38365608›Full record

ArticleBMC infectious diseases2024

The prehospital NEW score to assess septic shock in-hospital, 30-day and 90-day mortality.

Romain Jouffroy, Florian Négrello, Jean Limery, Basile Gilbert, Stéphane Travers, Emmanuel Bloch-Laine, Patrick Ecollan, Josiane Boularan, Vincent Bounes, Benoit Vivien and 1 more

Abstract read
In one paragraph

Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Romain JouffroyIntensive Care Unit, Ambroise Paré Hospital- Assistance Publique Hôpitaux Paris, 9 avenue Charles De Gaulle, 92100, Boulogne-Billancourt, Paris, France. romain.jouffroy@gmail.com.
Florian NégrelloSAMU 972, Centre Hospitalier Universitaire de Martinique, Fort-de-France Martinique, France.
Jean LimerySAMU 972, Centre Hospitalier Universitaire de Martinique, Fort-de-France Martinique, France.
Basile GilbertDepartment of Emergency Medicine, SAMU 31, University Hospital of Toulouse, Toulouse, France.
Stéphane TraversParis Fire Brigade, Paris, France.
Emmanuel Bloch-LaineEmergency Department, Cochin Hospital, Paris, France.
Patrick EcollanIntensive Care Unit, SMUR, Pitie Salpêtriere Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France.
Josiane BoularanCentre Hospitalier Intercommunal Castres-Mazamet, Castres, France.
Vincent BounesDepartment of Emergency Medicine, SAMU 31, University Hospital of Toulouse, Toulouse, France.
Benoit VivienIntensive Care Unit, Anaesthesiology, SAMU, Necker Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
Papa GueyeSAMU 972, Centre Hospitalier Universitaire de Martinique, Fort-de-France Martinique, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe early identification of sepsis presenting a high risk of deterioration is a daily challenge to optimise patient pathway. This is all the most crucial in the prehospital setting to optimize triage and admission into the appropriate unit: emergency department (ED) or intensive care unit (ICU). We report the association between the prehospital National Early Warning Score 2 (NEWS-2) and in-hospital, 30 and 90-day mortality of SS patients cared for in the pre-hospital setting by a mobile ICU (MICU).

methodsSeptic shock (SS) patients cared for by a MICU between 2016, April 6th and 2021 December 31st were included in this retrospective cohort study. The NEWS-2 is based on 6 physiological variables (blood pressure, heart rate, respiratory rate, temperature, oxygen saturation prior oxygen supplementation, and level of consciousness) and ranges from 0 to 20. The Inverse Probability Treatment Weighting (IPTW) propensity method was applied to assess the association with in-hospital, 30 and 90-day mortality. A NEWS-2 ≥ 7 threshold was chosen for increased clinical deterioration risk definition and usefulness in clinical practice based on previous reports.

resultsData from 530 SS patients requiring MICU intervention in the pre-hospital setting were analysed. The mean age was 69 ± 15 years and presumed origin of sepsis was pulmonary (43%), digestive (25%) or urinary (17%) infection. In-hospital mortality rate was 33%, 30 and 90-day mortality were respectively 31% and 35%. A prehospital NEWS-2 ≥ 7 is associated with an increase in-hospital, 30 and 90-day mortality with respective RRa = 2.34 [1.39-3.95], 2.08 [1.33-3.25] and 2.22 [1.38-3.59]. Calibration statistic values for in-hospital mortality, 30-day and 90-day mortality were 0.54; 0.55 and 0.53 respectively.

conclusionA prehospital NEWS-2 ≥ 7 is associated with an increase in in-hospital, 30 and 90-day mortality of septic shock patients cared for by a MICU in the prehospital setting. Prospective studies are needed to confirm the usefulness of NEWS-2 to improve the prehospital triage and orientation to the adequate facility of sepsis.

Indexed as

Emergency Medical ServicesSepsisShock, SepticAgedAged, 80 and overHospital MortalityHospitalsHumansIntensive Care UnitsMiddle AgedRetrospective StudiesTriageAssessmentNational early warning score 2Prehospital settingSeptic shockSeverityTriage

Identifiers

PMID38365608
PMCPMC10873999

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.