The Role of The National Early Warning Score (NEWS) in Identifying Critically Ill Patients at Risk of Mortality in Nigeria. A Retrospective Record Review.

Autor: Davwar PM; Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria., David NP; Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria., Imoh LC; Department of Chemical Pathology, Jos University Teaching Hospital, Jos, Nigeria., Imoh J; Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria.; Department of Chemical Pathology, Jos University Teaching Hospital, Jos, Nigeria.; Department of Geography and Planning University of Jos, Jos, Nigeria.; Department of General Internal Medicine, North Tees, and Hartlepool NHS foundation trust, United Kingdom.; Department of Internal Medicine, Federal Teaching Hospital, Gombe, Nigeria., Ahmed IS; Department of General Internal Medicine, North Tees, and Hartlepool NHS foundation trust, United Kingdom., Makpu JD; Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria., Duguru MJ; Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria., Zawaya K; Department of Internal Medicine, Federal Teaching Hospital, Gombe, Nigeria., Okeke EN; Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria.
Jazyk: angličtina
Zdroj: Nigerian medical journal : journal of the Nigeria Medical Association [Niger Med J] 2023 May 11; Vol. 64 (2), pp. 267-271. Date of Electronic Publication: 2023 May 11 (Print Publication: 2023).
Abstrakt: Background: Clinical deterioration in critically ill patients is a common phenomenon that can occur several hours before an adverse outcome. Early detection of subtle changes in vital signs, such as alterations in pulse rate and blood pressure, is crucial for preventing adverse events. However, these are not often recognized early enough to prompt quick intervention. The use of warning scores or assessment systems in the management of the critically ill in Nigeria has not been well evaluated. We assessed the association between the National Early Warning Score (NEWS) system and outcomes particularly mortality among the critically ill at the Jos University Teaching Hospital (JUTH), Nigeria.
Methodology: This study is a retrospective study involving adults admitted to the medical and surgical wards between January 2021 and July 2021. Patient medical records were used to obtain data such as socio-demographics, and vital signs, which were used to compute the NEWS variable, diagnosis, length of stay, outcomes, and complications. Patients were classified as low, medium, and high-risk based on their NEWS scores within the first 24 hours of admission and 24 hours prior to the outcome of interest (death or discharge).
Results: A total of 405 patients were included in this study. Patients with low, medium, and high-risk NEWS scores within the first 24 hours of admission, had an 11.1%, 9%, and 17% chance of death respectively. In the NEWS score high-risk group 24 hours prior to outcome (death or discharge), the risk of mortality increased to 20.6% and there was a four-fold increase in odds of death.
Conclusion: Our results showed that the NEWS score predicted outcome and may suggest that the implementation of the NEWS score as a routine tool for monitoring inpatients at the Jos University Teaching Hospital could help to detect patients at risk of adverse events.
(Copyright © 2023 Nigerian Medical Association.)
Databáze: MEDLINE
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