National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care

Objective. To evaluate the ability of the NEWS2-L (National Early Warning Score 2 Lactate) scale to predict the risk of early clinical deterioration (mortality within 48 hours) in patients with dyspnoea treated by the Medical Emergency Services compared with NEWS2 and lactate in isolation. Methods...

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Autores principales:	Raúl Villanueva Rábano, Francisco Martín-Rodríguez, Raúl López-Izquierdo
Formato:	article
Lenguaje:	EN
Publicado:	Universidad de Antioquia 2021
Materias:	dypsnea biomarkers prehospital care early warning score hospital mortality clinical decision-making Nursing RT1-120
Acceso en línea:	https://doaj.org/article/6cc86abcb4d4438e95ff1b2bac6de041
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spelling	oai:doaj.org-article:6cc86abcb4d4438e95ff1b2bac6de0412021-11-26T19:21:54ZNational Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care2216-028010.17533/udea.iee.v39n3e05https://doaj.org/article/6cc86abcb4d4438e95ff1b2bac6de0412021-10-01T00:00:00Zhttps://revistas.udea.edu.co/index.php/iee/article/view/347884https://doaj.org/toc/2216-0280Objective. To evaluate the ability of the NEWS2-L (National Early Warning Score 2 Lactate) scale to predict the risk of early clinical deterioration (mortality within 48 hours) in patients with dyspnoea treated by the Medical Emergency Services compared with NEWS2 and lactate in isolation. Methods. Prospective, multi-centre study of a cohort of 638 patients with dyspnoea treated in the ambulance and priority-transferred to a hospital emergency service in the cities of Valladolid, Salamanca, Segovia or Burgos (Spain). We collected clinical, analytical and demographic data. The main outcome measure was all-cause mortality within 48 hours. The recommendations of the Royal College of Physicians were followed to calculate NEWS2. When NEWS2 and LA prehospital values were obtained, the two values were added together to obtain the NEWS2-L. Results. Mortality within 48 hours was fifty-six patients (8.8%). The NEWS2-L scale obtained an area under the curve (AUC) of the receiver operating characteristics (ROC) for mortality within 48 hours of 0.854 (CI 95% 0.790–0.917), at seven days of 0.788 (CI 95% 0.729–0.848) and at 30 days of 0.744 (CI 95% 0.692–0.796); in all cases p<0.001, with a significant decrease between the value at 48 hours and at 30 days. Conclusion. The NEWS2-L scale was found to be significantly superior to the NEWS2 scale and similar to lactate in predicting early clinical deterioration in patients with dyspnoea. This scale can help a nurse detect these patients early, as part of their regular practice, and thus guide therapeutic efforts.Raúl Villanueva RábanoFrancisco Martín-RodríguezRaúl López-IzquierdoUniversidad de Antioquiaarticledypsneabiomarkersprehospital careearly warning scorehospital mortalityclinical decision-makingNursingRT1-120ENInvestigación y Educación en Enfermería, Vol 39, Iss 3 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	dypsnea biomarkers prehospital care early warning score hospital mortality clinical decision-making Nursing RT1-120
spellingShingle	dypsnea biomarkers prehospital care early warning score hospital mortality clinical decision-making Nursing RT1-120 Raúl Villanueva Rábano Francisco Martín-Rodríguez Raúl López-Izquierdo National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care
description	Objective. To evaluate the ability of the NEWS2-L (National Early Warning Score 2 Lactate) scale to predict the risk of early clinical deterioration (mortality within 48 hours) in patients with dyspnoea treated by the Medical Emergency Services compared with NEWS2 and lactate in isolation. Methods. Prospective, multi-centre study of a cohort of 638 patients with dyspnoea treated in the ambulance and priority-transferred to a hospital emergency service in the cities of Valladolid, Salamanca, Segovia or Burgos (Spain). We collected clinical, analytical and demographic data. The main outcome measure was all-cause mortality within 48 hours. The recommendations of the Royal College of Physicians were followed to calculate NEWS2. When NEWS2 and LA prehospital values were obtained, the two values were added together to obtain the NEWS2-L. Results. Mortality within 48 hours was fifty-six patients (8.8%). The NEWS2-L scale obtained an area under the curve (AUC) of the receiver operating characteristics (ROC) for mortality within 48 hours of 0.854 (CI 95% 0.790–0.917), at seven days of 0.788 (CI 95% 0.729–0.848) and at 30 days of 0.744 (CI 95% 0.692–0.796); in all cases p<0.001, with a significant decrease between the value at 48 hours and at 30 days. Conclusion. The NEWS2-L scale was found to be significantly superior to the NEWS2 scale and similar to lactate in predicting early clinical deterioration in patients with dyspnoea. This scale can help a nurse detect these patients early, as part of their regular practice, and thus guide therapeutic efforts.
format	article
author	Raúl Villanueva Rábano Francisco Martín-Rodríguez Raúl López-Izquierdo
author_facet	Raúl Villanueva Rábano Francisco Martín-Rodríguez Raúl López-Izquierdo
author_sort	Raúl Villanueva Rábano
title	National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care
title_short	National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care
title_full	National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care
title_fullStr	National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care
title_full_unstemmed	National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care
title_sort	national early warning score 2 lactate (news2-l) in predicting early clinical deterioration in patients with dyspnoea in prehospital care
publisher	Universidad de Antioquia
publishDate	2021
url	https://doaj.org/article/6cc86abcb4d4438e95ff1b2bac6de041
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National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care

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