Predictive value of the prehospital NEWS2-L —National Early Warning Score 2 Lactate— for detecting early death after an emergency
Martín-Rodríguez F, López-Izquierdo R, del Pozo Vegas C, Delgado Benito JF, del Brio Ibáñez P, Moro Mangas I, Martín Conty JL, Castro Villamor MA
Affiliation of the authors
Unidad Móvil de Emergencias, Gerencia de Emergencias Sanitarias de Castilla y León (SACYL), Spain. Centro de Simulación Clínica Avanzada, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain. Servicio de Urgencias, Hospital Universitario Río Hortega de Valladolid (SACYL), Valladolid, Spain. Servicio de Urgencias, Hospital Clínico Universitario de Valladolid (SACYL), Valladolid, Spain. Facultad de Terapia Ocupacional, Logopedia y Enfermería, Universidad de Castilla-La Mancha, Spain
Martín-Rodríguez F, López-Izquierdo R, del Pozo Vegas C, Delgado Benito JF, del Brio Ibáñez P, Moro Mangas I, et al. Predictive value of the prehospital NEWS2-L —National Early Warning Score 2 Lactate— for detecting early death after an emergency. Emergencias. 2019;31:173-9
Summary
Objectives.
To evaluate the ability of the prehospital National Early Warning Score 2 Lactate (preNEWS2-L) to predict early mortality, defined as death within 48 hours of the index event. We also explored the predictive capacity of the score for 7- and 30-day all-cause mortality.
Methods.
Prospective, observational longitudinal study in patients attended by ambulance responders and transferred to the emergency departments of reference hospitals. We collected demographic, physiologic, clinical, and analytical data and the main diagnosis. The main outcome measure was all-cause mortality.
Results.
A total of 707 patients were included. Thirty-seven patients (5.2%) died within 48 hours of the index event. The area under the receiver operating characteristic curve (AUC) for the preNEWS2-L score’s prediction of early death was 0.91 (95% CI, 0.83-0.96). The AUCs for death within 7 and 30 days were 0.86 (95% CI, 0.79-0.92) and 0.82 (95% CI, 0.76-0.87), respectively, showing that the score’s ability to predict death decreases by almost 10% between 48 hours and 30 days.
Conclusion. The preNEWS2-L is a useful prognostic tool that can be assessed quickly and easily in prehospital settings
