1. Is NEWS suitable for use in surgical patients?
Caroline Kovacs, CHMI
Healthy Computing June 2015

2. Background National Early Warning Score = NEWS
Based on vital signs observations
Developed in Medical Assessment Unit
Identify deteriorating patient earlier
Adopted by two thirds of hospitals throughout the UK
7 vital signs observations: Pulse, Respiration rate, temperature, bp systolic, O2 Sats, On O2, Level of Consciousness.
Max NEWS: 19

3. Method Hospital-wide data filtered into two datasets:
Admissions to medical specialities: pce
Admissions to surgical specialities: pce
Then: elective & non-elective admissions
Demographics & means compared
*pce = patient care episode
Data: 25 May 2011 to 31 Dec 2013, where patient not well enough to be discharged on day of admission
Complete observation sets used – sufficient to calculate NEWS
Medicine: Elective pce: 3,478 Emergency: 48,748
Surgery pce: Elective: 14, Emergency: 20,626

4. Max NEWS recorded: 19

5. AUROC…
NEWS’ ability to discriminate patients suffering/not suffering adverse outcome at 24 hours post vital signs observation assessed using area under receiver operating characteristic curve or AUROC
Eg. Risk of death:
Non-elective medical adms: 0.90
Non-elective surgical adms: 0.91

6. AUROC…

7. Efficiency curve – Combined outcome
NEWS 5
NEWS 4

8. Conclusion & future work…
Our results show NEWS is suitable for use with Surgical patients, but our research suggests a change of trigger level to NEWS 4 rather than NEWS 5 as recommended by RCP London
Incorporation of Operating Theatre data for further analysis