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Using the National Early Warning Score (NEWS/NEWS 2) in different Intensive Care Units (ICUs) to predict the discharge location of patients

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Using the National Early Warning Score (NEWS/NEWS 2) in different Intensive Care Units (ICUs) to predict the discharge location of patients. / Zaidi, Hassan; Bader-El-Den, Mohamed; McNicholas, James.

In: BMC Public Health, Vol. 19, 1231, 05.09.2019.

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@article{5b305346ced74cc0a2d92ab92ee62d36,
title = "Using the National Early Warning Score (NEWS/NEWS 2) in different Intensive Care Units (ICUs) to predict the discharge location of patients",
abstract = "Background: The National Early Warning Score (NEWS/NEWS 2) has been adopted across the National Health Service (NHS) in the U.K. as a method of escalating care for deteriorating patients. Intensive Care Unit (ICU) resources are limited and in high demand, with patient discharge a focal point for managing resources effectively. There are currently no universally accepted methods for assessing discharge of patients from an ICU, which can cause premature discharges and put patients at risk of subsequent deterioration, readmission to ICU or death.Methods: We tested the ability of the NEWS to discriminate patients within 24h of admission to an ICU in a U.S. hospital during 2001–2012, by their end discharge location: home; hospital ward; nursing facility; hospice and death. The NEWS performance was compared across five different ICU specialties, using the area under the receiver operating characteristic (AUROC) curve and a large vital signs database (n=2,723,055) collected from 28,523 critical care admissions.Results: The NEWS AUROC (95% CI) at 24h following admission: all patients 0.727 (0.709–0.745); Coronary Care Unit (CCU) 0.829 (0.821–0.837); Cardiac Surgery Recovery Unit (CSRU) 0.844 (0.838–0.850); Medical Intensive Care Unit (MICU) 0.778 (0.767–0.791); Surgical Intensive Care Unit (SICU) 0.775 (0.762–0.788); Trauma Surgical Intensive Care Unit (TSICU) 0.765 (0.751–0.773).Conclusions: The NEWS has reasonable discrimination for any ICU patient{\textquoteright}s discharge location. The NEWS has greater ability to discriminate patients in the Coronary Care Unit (CCU) and Cardiac Surgery Recovery Unit (CSRU) compared to other ICU specialties. The NEWS has the real potential to be applied within a universal discharge planning tool for ICU, improving patient safety at the point of discharge.",
keywords = "patient discharge, discharge location, patient outcomes, intensive care unit, national early warning score, vital signs, decision making, outcome prediction",
author = "Hassan Zaidi and Mohamed Bader-El-Den and James McNicholas",
year = "2019",
month = sep,
day = "5",
doi = "10.1186/s12889-019-7541-3",
language = "English",
volume = "19",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Using the National Early Warning Score (NEWS/NEWS 2) in different Intensive Care Units (ICUs) to predict the discharge location of patients

AU - Zaidi, Hassan

AU - Bader-El-Den, Mohamed

AU - McNicholas, James

PY - 2019/9/5

Y1 - 2019/9/5

N2 - Background: The National Early Warning Score (NEWS/NEWS 2) has been adopted across the National Health Service (NHS) in the U.K. as a method of escalating care for deteriorating patients. Intensive Care Unit (ICU) resources are limited and in high demand, with patient discharge a focal point for managing resources effectively. There are currently no universally accepted methods for assessing discharge of patients from an ICU, which can cause premature discharges and put patients at risk of subsequent deterioration, readmission to ICU or death.Methods: We tested the ability of the NEWS to discriminate patients within 24h of admission to an ICU in a U.S. hospital during 2001–2012, by their end discharge location: home; hospital ward; nursing facility; hospice and death. The NEWS performance was compared across five different ICU specialties, using the area under the receiver operating characteristic (AUROC) curve and a large vital signs database (n=2,723,055) collected from 28,523 critical care admissions.Results: The NEWS AUROC (95% CI) at 24h following admission: all patients 0.727 (0.709–0.745); Coronary Care Unit (CCU) 0.829 (0.821–0.837); Cardiac Surgery Recovery Unit (CSRU) 0.844 (0.838–0.850); Medical Intensive Care Unit (MICU) 0.778 (0.767–0.791); Surgical Intensive Care Unit (SICU) 0.775 (0.762–0.788); Trauma Surgical Intensive Care Unit (TSICU) 0.765 (0.751–0.773).Conclusions: The NEWS has reasonable discrimination for any ICU patient’s discharge location. The NEWS has greater ability to discriminate patients in the Coronary Care Unit (CCU) and Cardiac Surgery Recovery Unit (CSRU) compared to other ICU specialties. The NEWS has the real potential to be applied within a universal discharge planning tool for ICU, improving patient safety at the point of discharge.

AB - Background: The National Early Warning Score (NEWS/NEWS 2) has been adopted across the National Health Service (NHS) in the U.K. as a method of escalating care for deteriorating patients. Intensive Care Unit (ICU) resources are limited and in high demand, with patient discharge a focal point for managing resources effectively. There are currently no universally accepted methods for assessing discharge of patients from an ICU, which can cause premature discharges and put patients at risk of subsequent deterioration, readmission to ICU or death.Methods: We tested the ability of the NEWS to discriminate patients within 24h of admission to an ICU in a U.S. hospital during 2001–2012, by their end discharge location: home; hospital ward; nursing facility; hospice and death. The NEWS performance was compared across five different ICU specialties, using the area under the receiver operating characteristic (AUROC) curve and a large vital signs database (n=2,723,055) collected from 28,523 critical care admissions.Results: The NEWS AUROC (95% CI) at 24h following admission: all patients 0.727 (0.709–0.745); Coronary Care Unit (CCU) 0.829 (0.821–0.837); Cardiac Surgery Recovery Unit (CSRU) 0.844 (0.838–0.850); Medical Intensive Care Unit (MICU) 0.778 (0.767–0.791); Surgical Intensive Care Unit (SICU) 0.775 (0.762–0.788); Trauma Surgical Intensive Care Unit (TSICU) 0.765 (0.751–0.773).Conclusions: The NEWS has reasonable discrimination for any ICU patient’s discharge location. The NEWS has greater ability to discriminate patients in the Coronary Care Unit (CCU) and Cardiac Surgery Recovery Unit (CSRU) compared to other ICU specialties. The NEWS has the real potential to be applied within a universal discharge planning tool for ICU, improving patient safety at the point of discharge.

KW - patient discharge

KW - discharge location

KW - patient outcomes

KW - intensive care unit

KW - national early warning score

KW - vital signs

KW - decision making

KW - outcome prediction

U2 - 10.1186/s12889-019-7541-3

DO - 10.1186/s12889-019-7541-3

M3 - Article

VL - 19

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

M1 - 1231

ER -

ID: 15689160