Aim National Early Warning Score (NEWS)1 has been shown to be the best early warning score to predict in-hospital mortality.2 A single study also supports it’s use in a prehospital setting.3 The aim of the current retrospective cohort study was to investigate the association of prehospital NEWS and mortality using large population based databases.
Methods We analysed prehospital electronic patient record data to calculate NEWS values and compared these to national mortality data. We included all patient records for patients 18 years or older with sufficient prehospital data to calculate NEWS from 17 August 2008 to 18 December 2015 encountered by the emergency medical services (EMS) in the Hospital District of Helsinki and Uusimaa, Finland. The primary outcome measure was death within one day of EMS dispatch.
Results 35 845 cases were included. Mean age of patients was 65.8 years (SD 19.9 years). 47.5% of patients were male. Median NEWS was 3 (IQR 1–5). The primary outcome of death within one day of EMS dispatch occurred in 441 (1.2%) cases. The AUROC for primary outcome of death within one day was 0.502.
Conclusion In our retrospective cohort study, prehospital NEWS did not predict mortality within one day of EMS dispatch.
Williams B, Alberti G, Ball C, Bell D, Binks R, Durham L. National Early Warning Score (NEWS): Standardising the assessment of acute-illness severity in the NHS. London: The Royal College of Physicians; 2012
Smith GB, Prytherch DR, Meredith P, Schmidt PE, Featherstone PI. The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death. Resuscitation2013;84:465–70.
Silcock DJ, Corfield AR, Gowens PA, Rooney KD. Validation of the National Early Warning Score in the prehospital setting. Resuscitation2015;89:31–5.
Conflict of interest None declared.
Funding None declared.
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