National Early Warning Score Parameters at the Emergency Department as In Hospital Cardiac Arrest Predictors
Abstract
In Hospital Cardiac Arrest (IHCA) is fairly common occurrence, although it can be prevented. Physiological status monitoring at Emergency Departement (ED) is crucial for early detection of potential IHCA incidence. National Early Warning Score (NEWS) is a scoring system to assess deterioration of patient's condition, but it is not yet known which parameters that have predictive value for IHCA incidence. Examine NEWS parameters of the patients while at the ED that have predictive value of IHCA incidence. This study was conducted retrospectively on inpatient medical records. The NEWS parameters examined were respiration rate score, oxygen saturation score, body temperature score, systolic blood pressure score, pulse rate score and level of consciousness score. Logistic regression analysis was used to test the predictive ability of NEWS parameters. Total score NEWS proved to be correlated with IHCA incidence (p=0.000; r=0.434). Parameters that have predictive value are systolic blood pressure score (p=0.001; OR=14.730), respiration rate score (p=0.000; OR=14.483) and level of consciousness score (p=0.000; OR=6.920). The NEWS parameter when the patients will be transferred from ED to the wards that have predictive value for IHCA incidence are systolic blood pressure score, respiration rate score and level of consciousness score.
References
Abbott, T. E. F., Cron, N., Vaid, N., Ip, D., Torrance, H. D. T., & Emmanuel, J. (2018). Pre-hospital National Early Warning Score (NEWS) is associated with in-hospital mortality and critical care unit admission: A cohort study. Annals of Medicine and Surgery, 27, 17–21. https://doi.org/10.1016/j.amsu.2018.01.006
Andersen, L. W., Holmberg, M. J., Berg, K. M., Donnino, M. W., & Asger Granfeldt. (2019). In-Hospital Cardiac Arrest: A Review. NCBI. https://doi.org/10.1001/jama.2019.1696
Andersen, L. W., Young, W., Chase, M., Berg, K. M., Mortensen, S. J., Moskowitz, A., … Cocchi, M. N. (2016). The prevalence and significance of abnormal vital signs prior to in-hospital cardiac arrest. Resuscitation, 98, 112–117. https://doi.org/10.1016/j.resuscitation.2015.08.016
Churpek, M. M., Yuen, T. C., Huber, M. T., Park, S. Y., Hall, J. B., & Edelson, D. P. (2012). Predicting cardiac arrest on the wards: a nested case-control study. Chest, 141(5), 1170–1176. https://doi.org/10.1378/chest.11-1301
Considine, J., Jones, D., Pilcher, D., & Currey, J. (2016). Patient physiological status at the emergency department-ward interface and emergency calls for clinical deterioration during early hospital admission. Journal of Advanced Nursing, 72(6), 1287–1300. https://doi.org/10.1111/jan.12922
Fujiwara, S., Koike, T., Moriyasu, M., Nakagawa, M., Atagi, K., Lefor, A. K., & Fujitani, S. (2016). A retrospective study of in-hospital cardiac arrest. Acute Medicine & Surgery, 3(4), 320–325. https://doi.org/10.1002/ams2.193
Graham, R., McCoy, M., & Schultz, A. (2015). Strategies to improve cardiac arrest survival: a time to act. Institute of Medicine of the Nationale Academies, 3(2), 61–64. https://doi.org/10.1002/ams2.192
Kellett, J., Murray, A., Woodworth, S., & Huang, W. (2015). Trends in weighted vital signs and the clinical course of 44,531 acutely ill medical patients while in hospital. Acute Medicine, 14(1), 3–9.
Kementrian Kesehatan Republik Indonesia. (2016). Peraturan Menteri Kesehatan Republik Indonesia Nomor 19 tahun 2016 tentang Sistem Penanggulangan Gawat Darurat Terpadu, 1–18. Retrieved from http://hukor.kemkes.go.id/uploads/produk_hukum/PMK_No._19_ttg_Sistem_Penanggulangan_Gawat_Darurat_Terpadu_.pdf
Kim, L. K., Looser, P., Swaminathan, R. V, Horowitz, J., Friedman, O., Shin, J. H., … Feldman, D. N. (2016). Sex‐Based Disparities in Incidence, Treatment, and Outcomes of Cardiac Arrest in the United States, 2003–2012. Journal of the American Heart Association, 5(6). https://doi.org/10.1161/JAHA.116.003704
Merchant, R. M., Yang, L., Becker, L. B., Berg, R. A., Nadkarni, V., Nichol, G., … Investigators, A. H. A. G. W. T. G.-R. (2011). Incidence of treated cardiac arrest in hospitalized patients in the United States. Critical Care Medicine, 39(11), 2401–2406. https://doi.org/10.1097/CCM.0b013e3182257459
Nolan, J. P., Soar, J., Smith, G. B., Gwinnutt, C., Parrott, F., Power, S., … Rowan, K. (2014). Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit. Resuscitation, 85(8), 987–992. https://doi.org/10.1016/j.resuscitation.2014.04.002
Qvick, A., Radif, M., Brever, C., Myrvik, J. O., Schenk Gustafsson, K., & Djärv, T. (2018). Survival of in-hospital cardiac arrest in men and women in a large Swedish cohort. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 26(1), 108. https://doi.org/10.1186/s13049-018-0576-0
Royal College of Physicians. (2012). National Early Warning Score ( NEWS ), Standardising the assessment of acute-illness severity in the NHS. Retrieved from https://www.ombudsman.org.uk/sites/default/files/National Early Warning Score (NEWS) - Standardising the assessment of acute-illness severity in the NHS_0.pdf
Copyright (c) 2020 International Journal of Science and Society
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.