Evidence map›Paper›PMID 39403088›Full record

ArticleResuscitation plus2024

Physiological deterioration prior to in-hospital cardiac arrest: What does the National Early Warning Score-2 miss?

Sherif Gonem, Daniella Draicchio, Ayad Mohamed, Sally Wood, Kelly Shiel, Steve Briggs, Tricia M McKeever, Dominick Shaw

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Resuscitation plus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Observational
  2. Article
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

8 authors.

Sherif GonemDepartment of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Daniella DraicchioDepartment of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Ayad MohamedDepartment of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Sally WoodRecognise and Rescue, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Kelly ShielRecognise and Rescue, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Steve BriggsDigital and Information, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Tricia M McKeeverNIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK.
Dominick ShawNIHR Leicester Biomedical Research Centre, School of Medicine, University of Leicester, Leicester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim: To determine the frequency with which the National Early Warning Score-2 (NEWS-2) fails to detect physiological deterioration preceding in-hospital cardiac arrest (IHCA). Methods: We conducted a retrospective observational study of all adult patients (age ≥ 18) who had suffered an IHCA between 1st July 2019 and 31st December 2021 in two large acute hospitals located in an urban centre (Nottingham, UK). Clinical observations and case notes were examined for the period leading up to IHCA events to determine if there was evidence of physiological deterioration which warranted an urgent patient assessment, whether NEWS-2 was triggered, and whether an urgent assessment actually took place. Results: Urgent assessment was indicated in the lead-up to 126/374 (33.7 %) IHCA cases, and NEWS-2 failed to trigger in 20 of these cases (15.9 %). An urgent assessment took place in 89/106 (84.0 %) cases where NEWS-2 was triggered, and 13/20 (65.0 %) cases where NEWS-2 was not triggered, with the difference in proportions being statistically significant (p = 0.048). Half of cases in which NEWS-2 missed a physiological deterioration were related to a new or rising oxygen requirement. Conclusions: A significant proportion of IHCA events are preceded by clinically important abnormalities in vital signs which are not detected by NEWS-2. This may be a causative factor in some failure-to-rescue events.

Indexed as

Cardiac arrestClinical deteriorationEarly warning scoreRapid response teamVital signs

Identifiers

PMID39403088
PMCPMC11472090

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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.