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Is NEWS suitable for use in surgical patients?

Caroline Kovacs, CHMIHealthy Computing June 2015

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Background• National Early Warning Score = NEWS• Based on vital signs observations• Developed in Medical Assessment Unit• Identify deteriorating patient earlier• Adopted by two thirds of hospitals

throughout the UK

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Method

Hospital-wide data filtered into two datasets: • Admissions to medical specialities: 52 226 pce• Admissions to surgical specialities: 35 174 pce

Then: elective & non-elective admissionsDemographics & means compared

*pce = patient care episode

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0 1 2 3 4 5 6 7 8 9 100.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

0.00

5.00

10.00

15.00

20.00

25.00

NEWS distribution v mortality %

Surg % Obs Med % Obs Surg D24 risk% Med D24 risk%

NEWS

% Obs

% Risk

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AUROC…• NEWS’ ability to discriminate patients

suffering/not suffering adverse outcome at 24 hours post vital signs observation assessed using area under receiver operating characteristic curve or AUROC

• Eg. Risk of death: Non-elective medical adms: 0.90 Non-elective surgical adms: 0.91

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AUROC…

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Efficiency curve – Combined outcome

NEWS 5

NEWS 4

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Conclusion & future work…

• Our results show NEWS is suitable for use with Surgical patients, but our research suggests a change of trigger level to NEWS 4 rather than NEWS 5 as recommended by RCP London

• Incorporation of Operating Theatre data for further analysis