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The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients

Background The diagnosis of sepsis in the emergency department (ED) is difficult due to the ambiguous nature of its expression and its non-specific symptoms. Multiple scoring tools have been utilized to detect the severity and prognosis of sepsis. This study aimed to evaluate the use of the initial...

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Autores principales: Sardidi, Habibah, Bawazeer, Dalal, Alhafi, Mohammed, Alomran, Shadan, Sayed, Ghali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308202/
https://www.ncbi.nlm.nih.gov/pubmed/37398723
http://dx.doi.org/10.7759/cureus.39678
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author Sardidi, Habibah
Bawazeer, Dalal
Alhafi, Mohammed
Alomran, Shadan
Sayed, Ghali
author_facet Sardidi, Habibah
Bawazeer, Dalal
Alhafi, Mohammed
Alomran, Shadan
Sayed, Ghali
author_sort Sardidi, Habibah
collection PubMed
description Background The diagnosis of sepsis in the emergency department (ED) is difficult due to the ambiguous nature of its expression and its non-specific symptoms. Multiple scoring tools have been utilized to detect the severity and prognosis of sepsis. This study aimed to evaluate the use of the initial National Early Warning Score 2 (NEWS-2) at the ED as a predictive tool of in-hospital mortality in hemodialysis patients. Methodology We performed a retrospective, observational study to review the records of hemodialysis patients admitted to King Abdulaziz Medical City in Riyadh with suspected sepsis from the 1st of January to the 31st of December 2019 using a convenient sampling technique. Results The results showed that NEWS-2 had a higher sensitivity in predicting sepsis compared to the Quick Sequential Organ Failure Assessment (qSOFA) (16.28% vs. 11.54%). However, qSOFA had a higher specificity in predicting sepsis compared to the NEWS-2 scoring system (81.16% vs. 74.14%). It was found that the NEWS-2 scoring system was more sensitive in predicting mortality compared to qSOFA (26% vs. 20%). However, qSOFA was more specific in predicting mortality compared to NEWS-2 (88.50% vs. 82.98%). Conclusions Our findings demonstrated that the initial NEWS-2 is a subpar screening tool for sepsis and in-hospital mortality in hemodialysis patients. The use of qSOFA at the time of ED presentation was found to have a relatively higher specificity in predicting sepsis and mortality when compared to NEWS-2. To assess the application of the initial NEWS-2 in the ED setting, additional research should be conducted.
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spelling pubmed-103082022023-06-30 The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients Sardidi, Habibah Bawazeer, Dalal Alhafi, Mohammed Alomran, Shadan Sayed, Ghali Cureus Emergency Medicine Background The diagnosis of sepsis in the emergency department (ED) is difficult due to the ambiguous nature of its expression and its non-specific symptoms. Multiple scoring tools have been utilized to detect the severity and prognosis of sepsis. This study aimed to evaluate the use of the initial National Early Warning Score 2 (NEWS-2) at the ED as a predictive tool of in-hospital mortality in hemodialysis patients. Methodology We performed a retrospective, observational study to review the records of hemodialysis patients admitted to King Abdulaziz Medical City in Riyadh with suspected sepsis from the 1st of January to the 31st of December 2019 using a convenient sampling technique. Results The results showed that NEWS-2 had a higher sensitivity in predicting sepsis compared to the Quick Sequential Organ Failure Assessment (qSOFA) (16.28% vs. 11.54%). However, qSOFA had a higher specificity in predicting sepsis compared to the NEWS-2 scoring system (81.16% vs. 74.14%). It was found that the NEWS-2 scoring system was more sensitive in predicting mortality compared to qSOFA (26% vs. 20%). However, qSOFA was more specific in predicting mortality compared to NEWS-2 (88.50% vs. 82.98%). Conclusions Our findings demonstrated that the initial NEWS-2 is a subpar screening tool for sepsis and in-hospital mortality in hemodialysis patients. The use of qSOFA at the time of ED presentation was found to have a relatively higher specificity in predicting sepsis and mortality when compared to NEWS-2. To assess the application of the initial NEWS-2 in the ED setting, additional research should be conducted. Cureus 2023-05-30 /pmc/articles/PMC10308202/ /pubmed/37398723 http://dx.doi.org/10.7759/cureus.39678 Text en Copyright © 2023, Sardidi et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Sardidi, Habibah
Bawazeer, Dalal
Alhafi, Mohammed
Alomran, Shadan
Sayed, Ghali
The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients
title The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients
title_full The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients
title_fullStr The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients
title_full_unstemmed The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients
title_short The Use of the Initial National Early Warning Score 2 at the Emergency Department as a Predictive Tool of In-Hospital Mortality in Hemodialysis Patients
title_sort use of the initial national early warning score 2 at the emergency department as a predictive tool of in-hospital mortality in hemodialysis patients
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308202/
https://www.ncbi.nlm.nih.gov/pubmed/37398723
http://dx.doi.org/10.7759/cureus.39678
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