Comparing the prehospital NEWS with in-hospital ESI in predicting 30-day severe outcomes in emergency patients

Comparing the prehospital NEWS with in-hospital ESI in predicting 30-day severe outcomes in emergency patients

Emergency medical services, Early warning score, Triage, Emergency severity index, Patient outcome,
Smartphone

Background: In Iran, the emergency departments (EDs) have largely adopted the emergency severity index (ESI) to
prioritize the emergency patients, however emergency medical services (EMS) mainly triage the patients based on
the paramedics’ gestalt. The National Early Warning Score (NEWS) is a recommended prehospital triage in the UK. We
aimed to compare prehospital NEWS and ED ESI for predicting severe outcomes in emergency patients.
Methods: An observational study was conducted in a university-afliated ED between January and April 2021. Adult
patients who arrived in the ED by EMS were included. EMS providers calculated the patients’ NEWS upon arriving on
the scene using an Android NEWS application. In the ED, triage nurses utilized the ESI algorithm to prioritize patients
with higher clinical risk. Then, Research nurses recorded patients’ 30-day severe outcomes (death or ICU admission).
Finally, The prognostic properties of ESI and NEWS were evaluated.
Results: One thousand forty-eight cases were included in the fnal analysis, of which 29 (2.7%) patients experienced
severe outcomes. The diference between the prehospital NEWS and ED ESI in predicting severe outcomes was not
statistically signifcant (AUC=0.825, 95% CI: 0.74–0.91 and 0.897, 95% CI, 0.83–0.95, for prehospital NEWS and ESI,
respectively).
Conclusion: Our fndings indicated that prehospital NEWS compares favorably with ED ESI in predicting 30-day
severe outcomes in emergency patients.

Peyman Saberian, Atefeh Abdollahi, Parisa Hasani‑Sharamin, Maryam Modaber and Ehsan Karimialavijeh

BMC Emergency Medicine

(2022) 22:42

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