1. R16: DOES THE CUMULATIVE FRAILTY EARLY WARNING SCORE (FEWS) AND NEWS IMPROVE PREDICTOR POWER FOR VARIOUS PATIENT OUTCOMES IN THE ELDERLY ACUTE CARE POPULATION?
Lotte Dinesen1,2,Alan J Poots1, Federico Ciardi3, John Soong1, Derek Bell1,2
1 CLAHRC NWL/ Imperial College, 2 Chelsea and Westminster Hospital NHS FT, 3 Imperial College London
Aim
To assess the effect of combining FEWS and NEWS on selected outcome measures in an elderly population
Methods
FEWS is based on a frailty model described by Soong et al (2015) with four specific domains (physical, mental, social and environmental). Soong et al showed that addition of NEWS on admission seems to improve predictive power of the frailty model. We prospectively collected data from 1903 consecutive patients > 65yrs from 03 June Jan 2016, Data were collected from clinical notes taken routinely as part of the emergency admission process. We compared the correlation between FEWS and NEWS using point-biserial analysis.
Outcomes / Results
1903 patients were included with an average age was 81yrs (range ) and 53.8 %were female.
Mortality rates increase linearly for the cumulative NEWS and FEWS scores, however for readmission there is no correlation to be found ( Fig 1and 2). A linear correlation is seen with FEWS and NEWS additive score to LOS (fig 3).
Conclusion
This could indicate that cumulative FEWS and NEWS may confer improved predictive power for mortality (small) but not for readmission nor length of stay in cohort of elderly patients.
Figure 1. Graph showing relationship between cumulative FEWS and NEWS scores to mortality
Figure 2. Graph showing relationship between cumulative FEWS and NEWS to readmission frequencies
Figure 3. Line graph showing relationship between cumulative FEWS and NEWS to Length of Stay (Days)