The role of The National Early Warning Score (NEWS) in identifying critically ill patients at risk of mortality in Nigeria. A retrospective record review

Abstract

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. The records of all patients admitted to inpatient care at JUTH during a 6-month period were reviewed. 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). The study received ethical approval from the human research and ethics committee at JUTH.

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.