Prognostic Utility of the National Early Warning Score (NEWS) in Patients with Pulmonary Embolism

Authors

DOI:

https://doi.org/10.31247/agnj.v2iS1.49

Abstract

Background: Pulmonary embolism (PE) is a serious cardiovascular condition requiring accurate risk assessment at an early stage for effective clinical management. Our aim was to evaluate the prognostic value of the National Early Warning Score (NEWS) in patients admitted to an emergency department for PE.

Methods: We conducted a cohort study that included all hemodynamically stable adults (≥18 years) who were treated for PE in the Emergency Department of the Medical University of Vienna between January 2017 and December 2021. Regression analysis was used to assess the association between the NEWS and a composite outcome of 30-day all-cause mortality or extended therapy (i.e., systemic or local thrombolysis). Receiver operating characteristics (ROC) analysis was used to assess the prognostic performance of the NEWS and the Pulmonary Embolism Severity Index (PESI). The study was conducted in accordance with the Declaration of Helsinki (EKNr: 1102/2023).

Results: We included a total of 476 patients (mean age 61.5 years, SD 16.2; 47.7% women). The NEWS was significantly associated with 30-day mortality and need for extended therapy (odds ratio 1.75, 95% CI: 1.54 -1.99, p < 0.001) independently of the PESI. The area under the ROC curve for predicting outcome was 0.866 (95% CI: 0.825-0.907) for the NEWS and 0.754 (95% CI: 0.825-0.907) for the PESI (p < 0.001). In patients with a NEWS ≥7 (n=48), 52% received extended therapy. In these patients (n=25), mortality was 8% compared to 35% in patients who did not receive extended therapy (p=0.022).

Conclusion: The NEWS may be useful in the early risk assessment and management of patients with hemodynamically stable PE in the emergency department. Patients who exceed a NEWS of 7 points may benefit from extended therapy.

 

Published

2024-04-04

How to Cite

Prognostic Utility of the National Early Warning Score (NEWS) in Patients with Pulmonary Embolism. (2024). AGN Journal, 2(S1). https://doi.org/10.31247/agnj.v2iS1.49