Original articlePancreas, biliary tract, and liverNational Early Warning Score Accurately Discriminates the Risk of Serious Adverse Events in Patients With Liver Disease
Section snippets
Patients and Methods
The Isle of Wight, Portsmouth, and Southeast Hampshire research ethics committees approved our study (ref. 08/02/1394).
Study Population
Categorizing patient episodes using the 4 clinical subgroups, 773 patients (1197 episodes) were discharged with a primary diagnosis of liver disease and 2525 (3953 episodes) were discharged with a nonprimary (comorbid) diagnosis. In the same period, if patient episodes were categorized using the 3 SHMI groups, 1216 patients (2016 episodes) were discharged with a primary diagnosis of liver disease and 4957 (6459 episodes) were discharged with a nonprimary (comorbid) diagnosis. After excluding
Discussion
In the United Kingdom, the Royal College of Physicians recommended that NEWS is deployed to standardize assessment of acute illness severity in hospitals. Our study was designed to test the hypothesis that NEWS might not accurately predict serious events in patients with liver disease owing to pre-existing altered physiology associated with the underlying condition. This hypothesis was disproven and we were encouraged to find that NEWS remained a highly accurate discriminator of adverse events
References (39)
- et al.
Review and performance evaluation of aggregate weighted “track and trigger” systems
Resuscitation
(2008) - et al.
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
Resuscitation
(2013) - et al.
Management of bacterial infections in cirrhosis
J Hepatol
(2012) - et al.
Hospital-wide physiological surveillance-a new approach to the early identification and management of the sick patient
Resuscitation
(2006) - et al.
ViEWS–towards a national early warning score for detecting adult inpatient deterioration
Resuscitation
(2010) - et al.
Mechanisms of decompensation and organ failure in cirrhosis: from peripheral arterial vasodilation to systemic inflammation hypothesis
J Hepatol
(2015) - et al.
A model to predict survival in patients with end-stage liver disease
Hepatology
(2001) - et al.
Corticosteroid therapy of alcoholic hepatitis
Gastroenterology
(1978) - et al.
Development and validation of a prognostic score to predict mortality in patients with acute on chronic liver failure
J Hepatol
(2014) - et al.
Sepsis in alcohol-related liver disease
J Hepatol
(2017)
Antibiotics prevent liver injury in rats following long-term exposure to ethanol
Gastroenterology
Toll-like receptor 4 is involved in the mechanism of early alcohol-induced liver injury in mice
Hepatology
Histological-hemodynamic correlation in cirrhosis-a histological classification of the severity of cirrhosis
J Hepatol
In-hospital cardiac arrest: is it time for an in-hospital “chain of prevention”?
Resuscitation
Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis
Gastroenterology
Sepsis in cirrhosis: report on the 7th meeting of the International Ascites Club
Gut
Early warning system scores for clinical deterioration in hospitalized patients: a systematic review
Ann Am Thorac Soc
Cited by (13)
The performance of the National Early Warning Score and National Early Warning Score 2 in hospitalised patients infected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
2021, ResuscitationCitation Excerpt :In addition, the results demonstrate that NEWS and NEWS2 remain highly relevant for illness severity assessment, even for patients suffering a completely novel disease that has emerged some years after the two scoring systems were developed. Previous research into the performance of NEWS or NEWS2 for 24 h outcomes shows similar AUROC values to those found in the current study.2–6,13,15 Consequently, our results support the continued adherence to the national and international guidance on the use of the systems in patients with COVID-19.20–22
Development of the National Early Warning Score-Calcium Model for Predicting Adverse Outcomes in Patients With Acute Pancreatitis
2020, Journal of Emergency NursingCitation Excerpt :The timely detection of SAP in patients is vital because early intensive care could be performed to reduce the morbidity and mortality of the disease. Previous studies have reported a high value of NEWS in predicting the hospitalization and in-hospital mortality of geriatric patients in the emergency department,10 30-day death risk of community-acquired pneumonia,17 and death risk within a 24-hour period for a range of liver-related diagnoses.18 However, few studies have applied NEWS to assess the severity of AP.
NEWSworthy but Not Ready for Prime Time
2018, Clinical Gastroenterology and Hepatology
Conflicts of interest These authors disclose the following: Paul E. Schmidt, Richard J. Aspinall, and Paul Meredith are employed by Portsmouth Hospitals NHS Trust. Gary B. Smith and David R. Prytherch were employees of Portsmouth Hospitals NHS Trust until March 31, 2011, and July 31, 2016, respectively. Paul E. Schmidt, and the wives of Gary B. Smith and David R. Prytherch, were shareholders in The Learning Clinic Ltd at the time of the study. Gary B. Smith, David R. Prytherch, and Paul E. Schmidt were unpaid research advisors to The Learning Clinic Ltd until May 2016. Gary B. Smith and David R. Prytherch have received reimbursement of travel expenses from The Learning Clinic Ltd. for attending symposia in the United Kingdom. The remaining author discloses no conflicts.
VitalPAC is a trade name of The Learning Clinic Limited. Vitalpac is part of System C Healthcare (www.systemc.com). VitalPAC is a collaborative development of The Learning Clinic Ltd and Portsmouth Hospitals NHS Trust. At the time of the study, Portsmouth Hospitals NHS Trust had a royalty agreement with The Learning Clinic Ltd to pay for the use of Portsmouth Hospitals NHS Trust intellectual property within the VitalPAC product.