THE EFFECT OF NATIONAL EARLY WARNING SCORING SYSTEM (NEWS2) IMPLEMENTATION ON IDENTIFYING THE RISK OF CLINICAL DETERIORATION AND OUTCOMES AMONG COVID-19 HOSPITALIZED PATIENTS
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Date
2022-08-15
Authors
Islam Mohammad Salem Tukhi
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Abstract
ABSTRACT
Background: Coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, has been declared a pandemic by the World Health Organization (WHO), and it is associated with high rates of mortality and morbidity, prolonged hospital stays, and increased needs for Intensive Care Unit (ICU) admission. It is crucial to predict clinical deterioration in COVID-19 patients.
Objectives: To find out the efficacy of the National Early Warning Scoring System (NEWS2) application in predicting the risk of clinical deterioration and outcomes in hospitalized patients who had COVID-19 at Martyrs Medical Military Complex and Palestinian Red Crescent hospital.
Methods: A quasi-experimental design was applied. A sample of 384 adult patients was divided into a research group (192 patients) and a control group (192 patients). Before and after implementation (NEWS 2), all study participants were observed until death or hospital discharge, and the results of the two patient groups were compared and assessed.
Results: Comparing the control group (Pre NEWS phase) to the study group (Post NEWS phase), a significant decrease was found in the mean length of hospital stay (8.1 ± 5.5 vs 6.4 ± 5.3, p = 0.002), as well as a reduction in the mortality rate from 38 (19.8 %) during the pre- NEWS phase to 24 (12.5 %) during the post-NEWS phase (p = 0.071).The predictive value of NEWS was found to be an excellent predictor of admission to the ICU as indicated by an AUROC of 0.91 (95% CI: 0.87-0.96, p < 0.001).
Also, a significant difference in the frequency of monitoring patients' vital signs was observed between the control group (Pre NEWS phase) and the study group (Post NEWS phase) following clinical deterioration (10.1 ± 7.8(Pre NEWS2) vs 23.4 ± 0.7(Post NEWS2), p = <0.001).
Conclusion: Implementation of NEWS2 showed a significant improvement in hospitalized COVID patient outcomes (length of stay, predicted ICU admissions, mortality rate and frequency of vital signs measurements, which indirectly raised the number of medical reviews following patient clinical deterioration) and this was attributed to a significant prediction of patient deterioration.
Keywords: COVID19; NEWS2; clinical deterioration; patient outcomes; and early warning scores.