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The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia

This study aimed to assess the predictive performance of the National Early Warning Score 2 (NEWS2) to identify the early progression to severe disease in patients with community-acquired pneumonia (CAP). A prospective-cohort study was conducted among patients with CAP admitted to a university hospi...

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Autores principales: Tajarernmuang, Pattraporn, Sanwirat, Pimchanok, Inchai, Juthamas, Phinyo, Phichayut, Limsukon, Atikun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962139/
https://www.ncbi.nlm.nih.gov/pubmed/36828485
http://dx.doi.org/10.3390/tropicalmed8020068
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author Tajarernmuang, Pattraporn
Sanwirat, Pimchanok
Inchai, Juthamas
Phinyo, Phichayut
Limsukon, Atikun
author_facet Tajarernmuang, Pattraporn
Sanwirat, Pimchanok
Inchai, Juthamas
Phinyo, Phichayut
Limsukon, Atikun
author_sort Tajarernmuang, Pattraporn
collection PubMed
description This study aimed to assess the predictive performance of the National Early Warning Score 2 (NEWS2) to identify the early progression to severe disease in patients with community-acquired pneumonia (CAP). A prospective-cohort study was conducted among patients with CAP admitted to a university hospital between October 2020 and December 2021. The endpoint of interest was the progression to severe CAP, defined as the requirement for a mechanical ventilator, a vasopressor, or death within 72 h after hospital admission. Among 260 patients, 53 (25.6%) had early progression to severe CAP. The median NEWS2 of the early progression group was higher than that of the non-progression group [8 (6–9) vs. 7 (5–8), p = 0.015, respectively]. The AUROC of NEWS2 to predict early progression to severe CAP was 0.61 (95% CI: 0.52–0.70), while IDSA/ATS minor criteria ≥ 3 had AUROC 0.56 (95% CI 0.48–0.65). The combination of NEWS2 ≥ 8, albumin level < 3 g/dL and BUN ≥ 30 mg/dL improved AUROC from 0.61 to 0.71 (p = 0.015). NEWS2 and IDSA/ATS minor criteria showed fair predictive-accuracy in predicting progression to severe CAP. The NEWS2 cut-off ≥ 8 in combination with low albumin and uremia improved predictive-accuracy, and could be easily used in general practice.
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spelling pubmed-99621392023-02-26 The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia Tajarernmuang, Pattraporn Sanwirat, Pimchanok Inchai, Juthamas Phinyo, Phichayut Limsukon, Atikun Trop Med Infect Dis Article This study aimed to assess the predictive performance of the National Early Warning Score 2 (NEWS2) to identify the early progression to severe disease in patients with community-acquired pneumonia (CAP). A prospective-cohort study was conducted among patients with CAP admitted to a university hospital between October 2020 and December 2021. The endpoint of interest was the progression to severe CAP, defined as the requirement for a mechanical ventilator, a vasopressor, or death within 72 h after hospital admission. Among 260 patients, 53 (25.6%) had early progression to severe CAP. The median NEWS2 of the early progression group was higher than that of the non-progression group [8 (6–9) vs. 7 (5–8), p = 0.015, respectively]. The AUROC of NEWS2 to predict early progression to severe CAP was 0.61 (95% CI: 0.52–0.70), while IDSA/ATS minor criteria ≥ 3 had AUROC 0.56 (95% CI 0.48–0.65). The combination of NEWS2 ≥ 8, albumin level < 3 g/dL and BUN ≥ 30 mg/dL improved AUROC from 0.61 to 0.71 (p = 0.015). NEWS2 and IDSA/ATS minor criteria showed fair predictive-accuracy in predicting progression to severe CAP. The NEWS2 cut-off ≥ 8 in combination with low albumin and uremia improved predictive-accuracy, and could be easily used in general practice. MDPI 2023-01-17 /pmc/articles/PMC9962139/ /pubmed/36828485 http://dx.doi.org/10.3390/tropicalmed8020068 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tajarernmuang, Pattraporn
Sanwirat, Pimchanok
Inchai, Juthamas
Phinyo, Phichayut
Limsukon, Atikun
The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia
title The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia
title_full The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia
title_fullStr The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia
title_full_unstemmed The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia
title_short The National Early Warning Score 2(NEWS2) to Predict Early Progression to Severe Community-Acquired Pneumonia
title_sort national early warning score 2(news2) to predict early progression to severe community-acquired pneumonia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962139/
https://www.ncbi.nlm.nih.gov/pubmed/36828485
http://dx.doi.org/10.3390/tropicalmed8020068
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