Poor specificity of National Early Warning Score (NEWS) in spinal cord injuries (SCI) population: a retrospective cohort study

Ahmed, W.A., Rouse, A., Griggs, K.E. ORCID: 0000-0002-1962-9613, Collett, J. and Dawes, H., 2019. Poor specificity of National Early Warning Score (NEWS) in spinal cord injuries (SCI) population: a retrospective cohort study. Spinal Cord. ISSN 1362-4393

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Abstract

Study design:

Retrospective chart audit.

Objectives:

The National Early Warning Score (NEWS) is based on seven physiological parameters which can be altered in some individuals with spinal cord injuries (SCI). The aim was to start the development of adapted NEWS suitable for SCI population. The objective was to determine the SBP NEWS specificity based on neurological level of injury (NLI) and completeness of injury.

Setting:

Tertiary centre in the UK.

Methods:

Adult patients admitted for the first time to the National Spinal Injuries Centre between 1st January 2015 and 31st December 2016 were included if they were > 6 months post-injury. Data were extracted retrospectively including the last ten consecutive BP and heart rate readings before discharge. Data were analysed based on different AIS grades, completeness of injury and NLI.

Results:

191 patients were admitted in 2015 and 2016 and 142 patients were included in the primary analysis. The mean SBP ranged between 92 and 151 mmHg. Patients with the NLI of T6 and above (≥ T6) motor complete lesions had a significantly lower SBP than motor incomplete lesions. The specificity of the SBP NEWS was 35.3% in ≥ T6 motor complete individuals versus 80.3 % in ≥ T6 motor incomplete individuals.

Conclusion:

The baseline BP is significantly lower in the ≥ T6 motor complete SCI individuals (> 6 months post-injury) resulting in a very low specificity of 35.3 % to SBP NEWS which could lead to mismatch between clinical deterioration and NEWS resulting in lack of timely clinical response.

Item Type: Journal article
Alternative Title: Poor specificity of NEWS in SCI population
Publication Title: Spinal Cord
Creators: Ahmed, W.A., Rouse, A., Griggs, K.E., Collett, J. and Dawes, H.
Publisher: Nature Research
Date: 29 July 2019
ISSN: 1362-4393
Identifiers:
NumberType
10.1038/s41393-019-0330-0DOI
Divisions: Schools > School of Science and Technology
Depositing User: Jill Tomkinson
Date Added: 15 Jul 2019 15:01
Last Modified: 03 Sep 2019 11:22
URI: http://irep.ntu.ac.uk/id/eprint/37079

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