Post‐intensive care unit respiratory failure in older patients liberated from intensive care unit and ventilator: The predictive value of the National Early Warning Score on intensive care unit discharge

2019 ◽  
Vol 19 (4) ◽  
pp. 317-322 ◽  
Author(s):  
Yu‐Chun Chen ◽  
Wen‐Kuang Yu ◽  
Hsin‐Kuo Ko ◽  
Sheng‐Wei Pan ◽  
Yen‐Wen Chen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Early Warning ◽  
Predictive Value ◽  
Older Patients ◽  
Intensive Care Unit Discharge ◽  
Early Warning Score ◽  
Unit Discharge ◽  
National Early Warning Score

scholarly journals The significance of National Early Warning Score for predicting prognosis and evaluating conditions of patients in resuscitation room

2018 ◽  
Vol 25 (6) ◽  
pp. 324-330 ◽  
Author(s):  
Wang Chang Yuan ◽  
Cao Tao ◽  
Zhu Dan Dan ◽  
Sun Chang Yi ◽  
Wang Jing ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Warning ◽  
Chronic Health Evaluation ◽  
Early Warning Score ◽  
Health Evaluation ◽  
Chronic Health ◽  
Resuscitation Room ◽  
Receiver Operating Characteristic Curves ◽  
National Early Warning Score

Background: For critical patients in resuscitation room, the early prediction of potential risk and rapid evaluation of disease progression would help physicians with timely treatment, leading to improved outcome. In this study, it focused on the application of National Early Warning Score on predicting prognosis and conditions of patients in resuscitation room. The National Early Warning Score was compared with the Modified Early Warning Score) and the Acute Physiology and Chronic Health Evaluation II. Objectives: To assess the significance of NEWS for predicting prognosis and evaluating conditions of patients in resuscitation rooms. Methods: A total of 621 consecutive cases from resuscitation room of Xuanwu Hospital, Capital Medical University were included during June 2015 to January 2016. All cases were prospectively evaluated with Modified Early Warning Score, National Early Warning Score, and Acute Physiology and Chronic Health Evaluation II and then followed up for 28 days. For the prognosis prediction, the cases were divided into death group and survival group. The Modified Early Warning Score, National Early Warning Score, and Acute Physiology and Chronic Health Evaluation II results of the two groups were compared. In addition, receiver operating characteristic curves were plotted. The areas under the receiver operating characteristic curves were calculated for assessing and predicting intensive care unit admission and 28-day mortality. Results: For the prognosis prediction, in death group, the National Early Warning Score (9.50 ± 3.08), Modified Early Warning Score (4.87 ± 2.49), and Acute Physiology and Chronic Health Evaluation II score (23.29 ± 5.31) were significantly higher than National Early Warning Score (5.29 ± 3.13), Modified Early Warning Score (3.02 ± 1.93), and Acute Physiology and Chronic Health Evaluation II score (13.22 ± 6.39) in survival group ( p < 0.01). For the disease progression evaluation, the areas under the receiver operating characteristic curves of National Early Warning Score, Modified Early Warning Score, and Acute Physiology and Chronic Health Evaluation II were 0.760, 0.729, and 0.817 ( p < 0.05), respectively, for predicting intensive care unit admission; they were 0.827, 0.723, and 0.883, respectively, for predicting 28-day mortality. The comparison of the three systems was significant ( p < 0.05). Conclusion: The performance of National Early Warning Score for predicting intensive care unit admission and 28-day mortality was inferior than Acute Physiology and Chronic Health Evaluation II but superior than Modified Early Warning Score. It was able to rapidly predict prognosis and evaluate disease progression of critical patients in resuscitation room.

scholarly journals Impact of Intensive Care Unit Readmissions on Patient Outcomes and the Evaluation of the National Early Warning Score to Prevent Readmissions: Literature Review

10.2196/13782 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e13782
Author(s):  
Heidi Mcneill ◽  
Saif Khairat
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Hospital Mortality ◽  
Patient Outcomes ◽  
Early Warning ◽  
Early Warning Score ◽  
Risk Stratification Tool ◽  
National Early Warning Score ◽  
The Impact

Background Intensive care unit (ICU) readmissions have been shown to increase a patient’s in-hospital mortality and length of stay (LOS). Despite this, no methods have been set in place to prevent readmissions from occurring. Objective The aim of this literature review was to evaluate the impact of ICU readmission on patient outcomes and to evaluate the effect of using a risk stratification tool, the National Early Warning Score (NEWS), on ICU readmissions. Methods A database search was performed on PubMed, Cumulative Index of Nursing and Allied Health Literature, Google Scholar, and ProQuest. In the initial search, 2028 articles were retrieved; after inclusion and exclusion criteria were applied, 12 articles were ultimately used in this literature review. Results This literature review found that patients readmitted to the ICU have an increased mortality rate and LOS at the hospital. The sample sizes in the reviewed studies ranged from 158 to 745,187 patients. Readmissions were most commonly associated with respiratory issues about 18% to 59% of the time. The NEWS has been shown to detect early clinical deterioration in a patient within 24 hours of transfer, with a 95% CI of 0.89 to 0.94 (P<.001), a sensitivity of 93.6% , and a specificity of 82.2%. Conclusions ICU readmissions are associated with worse patient outcomes, including hospital mortality and increased LOS. Without the use of an objective screening tool, the provider has been solely responsible for the decision of patient transfer. Assessment with the NEWS could be helpful in decreasing the frequency of inappropriate transfers and ultimately ICU readmission.

scholarly journals Impact of Intensive Care Unit Readmissions on Patient Outcomes and the Evaluation of the National Early Warning Score to Prevent Readmissions: Literature Review (Preprint)

2019 ◽  
Author(s):  
Heidi Mcneill ◽  
Saif Khairat
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Hospital Mortality ◽  
Patient Outcomes ◽  
Early Warning ◽  
Early Warning Score ◽  
Risk Stratification Tool ◽  
National Early Warning Score ◽  
The Impact

BACKGROUND Intensive care unit (ICU) readmissions have been shown to increase a patient’s in-hospital mortality and length of stay (LOS). Despite this, no methods have been set in place to prevent readmissions from occurring. OBJECTIVE The aim of this literature review was to evaluate the impact of ICU readmission on patient outcomes and to evaluate the effect of using a risk stratification tool, the National Early Warning Score (NEWS), on ICU readmissions. METHODS A database search was performed on PubMed, Cumulative Index of Nursing and Allied Health Literature, Google Scholar, and ProQuest. In the initial search, 2028 articles were retrieved; after inclusion and exclusion criteria were applied, 12 articles were ultimately used in this literature review. RESULTS This literature review found that patients readmitted to the ICU have an increased mortality rate and LOS at the hospital. The sample sizes in the reviewed studies ranged from 158 to 745,187 patients. Readmissions were most commonly associated with respiratory issues about 18% to 59% of the time. The NEWS has been shown to detect early clinical deterioration in a patient within 24 hours of transfer, with a 95% CI of 0.89 to 0.94 (<i>P</i>&lt;.001), a sensitivity of 93.6% , and a specificity of 82.2%. CONCLUSIONS ICU readmissions are associated with worse patient outcomes, including hospital mortality and increased LOS. Without the use of an objective screening tool, the provider has been solely responsible for the decision of patient transfer. Assessment with the NEWS could be helpful in decreasing the frequency of inappropriate transfers and ultimately ICU readmission.

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