The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis

James Malycha; Nazli Farajidavar; Marco A. F. Pimentel; Oliver Redfern; David A. Clifton; Lionel Tarassenko; Paul Meredith; David Prytherch; Guy Ludbrook; J. D. Young; Peter J. Watkinson

doi:10.1016/j.resuscitation.2019.04.002

The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis

James Malycha, Nazli Farajidavar, Marco A. F. Pimentel, Oliver Redfern, David A. Clifton, Lionel Tarassenko, Paul Meredith, David Prytherch, Guy Ludbrook, J. D. Young, Peter J. Watkinson

Research output: Contribution to journal › Article › peer-review

198 Downloads (Pure)

Abstract

Objectives - To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission.

Methods - A multi-centre, retrospective, observational cohort study was carried out in five hospitals from two UK NHS Trusts. Adult admissions with at least one complete set of vital sign observations recorded electronically were eligible. The primary outcome measure was an 'adverse event' which comprised either in-hospital death or unplanned ICU admission. Discrimination was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC).

Results - A cohort of 83,304 patients from a total of 271,363 adult admissions were prescribed oxygen. In this cohort, NEWS-FiO2 (AUROC 0.823, 95% CI 0.819-0.824) outperformed NEWS (AUORC 0.811, 95% CI 0.809-0.814) when predicting in-hospital death or unplanned ICU admission within 24 h of a complete set of vital sign observations.

Conclusions - NEWS-FiO2 generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.

Original language	English
Pages (from-to)	192-199
Number of pages	8
Journal	Resuscitation
Volume	139
Early online date	18 Apr 2019
DOIs	https://doi.org/10.1016/j.resuscitation.2019.04.002
Publication status	Published - Jun 2019

Access to Document

10.1016/j.resuscitation.2019.04.002

1-s2.0-S0300957219301145-mainFinal published version, 1.18 MBLicence: CC BY

Cite this

Malycha, J., Farajidavar, N., Pimentel, M. A. F., Redfern, O., Clifton, D. A., Tarassenko, L., Meredith, P., Prytherch, D., Ludbrook, G., Young, J. D., & Watkinson, P. J. (2019). The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis. Resuscitation, 139, 192-199. https://doi.org/10.1016/j.resuscitation.2019.04.002

@article{c0658987b4cd4465bdcc8003933bfea1,

title = "The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis",

abstract = "Objectives - To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission.Methods - A multi-centre, retrospective, observational cohort study was carried out in five hospitals from two UK NHS Trusts. Adult admissions with at least one complete set of vital sign observations recorded electronically were eligible. The primary outcome measure was an 'adverse event' which comprised either in-hospital death or unplanned ICU admission. Discrimination was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC).Results - A cohort of 83,304 patients from a total of 271,363 adult admissions were prescribed oxygen. In this cohort, NEWS-FiO2 (AUROC 0.823, 95% CI 0.819-0.824) outperformed NEWS (AUORC 0.811, 95% CI 0.809-0.814) when predicting in-hospital death or unplanned ICU admission within 24 h of a complete set of vital sign observations.Conclusions - NEWS-FiO2 generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.",

author = "James Malycha and Nazli Farajidavar and Pimentel, {Marco A. F.} and Oliver Redfern and Clifton, {David A.} and Lionel Tarassenko and Paul Meredith and David Prytherch and Guy Ludbrook and Young, {J. D.} and Watkinson, {Peter J.}",

year = "2019",

month = jun,

doi = "10.1016/j.resuscitation.2019.04.002",

language = "English",

volume = "139",

pages = "192--199",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier",

}

TY - JOUR

T1 - The effect of fractional inspired oxygen concentration on early warning score performance

T2 - a database analysis

AU - Malycha, James

AU - Farajidavar, Nazli

AU - Pimentel, Marco A. F.

AU - Redfern, Oliver

AU - Clifton, David A.

AU - Tarassenko, Lionel

AU - Meredith, Paul

AU - Prytherch, David

AU - Ludbrook, Guy

AU - Young, J. D.

AU - Watkinson, Peter J.

PY - 2019/6

Y1 - 2019/6

N2 - Objectives - To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission.Methods - A multi-centre, retrospective, observational cohort study was carried out in five hospitals from two UK NHS Trusts. Adult admissions with at least one complete set of vital sign observations recorded electronically were eligible. The primary outcome measure was an 'adverse event' which comprised either in-hospital death or unplanned ICU admission. Discrimination was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC).Results - A cohort of 83,304 patients from a total of 271,363 adult admissions were prescribed oxygen. In this cohort, NEWS-FiO2 (AUROC 0.823, 95% CI 0.819-0.824) outperformed NEWS (AUORC 0.811, 95% CI 0.809-0.814) when predicting in-hospital death or unplanned ICU admission within 24 h of a complete set of vital sign observations.Conclusions - NEWS-FiO2 generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.

AB - Objectives - To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission.Methods - A multi-centre, retrospective, observational cohort study was carried out in five hospitals from two UK NHS Trusts. Adult admissions with at least one complete set of vital sign observations recorded electronically were eligible. The primary outcome measure was an 'adverse event' which comprised either in-hospital death or unplanned ICU admission. Discrimination was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC).Results - A cohort of 83,304 patients from a total of 271,363 adult admissions were prescribed oxygen. In this cohort, NEWS-FiO2 (AUROC 0.823, 95% CI 0.819-0.824) outperformed NEWS (AUORC 0.811, 95% CI 0.809-0.814) when predicting in-hospital death or unplanned ICU admission within 24 h of a complete set of vital sign observations.Conclusions - NEWS-FiO2 generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.

U2 - 10.1016/j.resuscitation.2019.04.002

DO - 10.1016/j.resuscitation.2019.04.002

M3 - Article

C2 - 31005587

SN - 0300-9572

VL - 139

SP - 192

EP - 199

JO - Resuscitation

JF - Resuscitation

ER -

The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis

Abstract

Access to Document

Fingerprint

Cite this