Utility of the New Early Warning Score (NEWS) in combination with the neutrophil–lymphocyte ratio for the prediction of prognosis in older patients with pneumonia
| Autor: | Kazuhiko Kotani, Eiichi Kakehi, Seiji Adachi, Ryo Uehira, Nobuaki Ohara, Yukinobu Akamatsu, Taeko Osaka, Shigehisa Sakurai, Akane Hirotani, Takafumi Nozaki, Keisuke Shoji |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Family Medicine and Community Health, Vol 11, Iss 2 (2023) |
| Druh dokumentu: | article |
| ISSN: | 2305-6983 2009-8774 |
| DOI: | 10.1136/fmch-2023-002239 |
| Popis: | Objective Predictors of prognosis are necessary for use in routine clinical practice for older patients with pneumonia, given the ageing of the population. Recently, the National Early Warning Score (NEWS), a comprehensive predictor of severity that consists solely of physiological indicators, has been proposed to predict the prognosis of pneumonia. The neutrophil/lymphocyte ratio (NLR) is a simple index of inflammation that may also be predictive of pneumonia. In the present study, we aimed to determine whether NEWS or a combination of NEWS and NLR predicts mortality in older patients with pneumonia.Design A retrospective cohort study.Setting A general hospital in Japan.Participants We collected data from patients aged ≥65 years with pneumonia who were admitted between 2018 and 2020 (n=282; age=85.3 (7.9)). Data regarding vital signs, demographics and the length of hospital stay, in addition to the NEWS and NLR, were extracted from the participants’ electronic medical records.Intervention The utility of the combination of NEWS and NLR was assessed using NEWS×NLR and NEWS+NLR.Main outcome measures Their predictive ability for 30-day mortality as the primary outcome was assessed using receiver operating characteristic (ROC) curve analysis.Results According to the NEWS classification, 80 (28.3%), 64 (22.7%) and 138 (48.9%) of the participants were at low, medium and high risk of mortality, respectively. The 30-day mortality for the entire cohort was 9.2% (n=26), and the mortality rate increased with the NEWS classification: low, 1.3%; medium, 7.8%; and high, 14.5%. The NLRs were 6.0 (4.2–9.8), 6.8 (4.8–10.4) and 14.6 (9.4–22.2), respectively (p |
| Databáze: | Directory of Open Access Journals |
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