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Validation of modified early warning score using serum lactate level in community-acquired pneumonia patients. The National Early Warning Score-Lactate score.

Title
Validation of modified early warning score using serum lactate level in community-acquired pneumonia patients. The National Early Warning Score-Lactate score.
Author
박보영
Keywords
LOW-RISK PATIENTS; VIEWS-L SCORE; HOSPITALIZED-PATIENTS; PREDICTING MORTALITY; SEVERITY; TRIAL; METAANALYSIS; ARTERIAL; ADULTS
Issue Date
2016-03
Publisher
W B SAUNDERS CO-ELSEVIER INC
Citation
AMERICAN JOURNAL OF EMERGENCY MEDICINE, v. 34, NO 3, Page. 536-541
Abstract
Study objective: The aim of this study was to investigate the prognostic prediction power of a newly introduced early warning score modified by serum lactate level, the National Early Warning Score-Lactate (NEWS-L) score, among community-acquired pneumonia (CAP) patients. We also compared the NEWS-L score with the pneumonia severity index (PSI) and CURB-65. Methods: We designed a retrospective observational study and collected data on confirmed adult CAP patients who visited the study hospital between October 2013 and September 2014. Variables relevant to, the NEWS-L score, PSI, and CURB-65 were extracted from electronic medical records. Survival status at hospital discharge was determined in the same manner. The NEWS-L score was calculated as NEWS-L=NEWS + serum lactate level (mmol/L). The NEWS-L was divided into quartiles. The ability to predict mortality was assessed through area under the receiver operating characteristic curve analysis and calibration analysis. Results: A total of 553 patients were enrolled, and the inpatient mortality rate was 10.8% (n=60). Mortality rates increased incrementally in conjunction with the NEWS-L quartiles: first quartile, 2.2%; second quartile, 7.9%; third quartile, 9.6%; and fourth quartile, 23.9%. The area under the receiver operating characteristic curve of the NEWS-L score was 0.73 (95% confidence interval [CI], 0.66-0.80), which showed no significant difference from that of the PSI (0.68; 95% CI, 0.61-0.76; P=.28) and CURB-65 (0.66; 95% CI, 0.59-0.73; P=.06). Conclusions: The newly introduced early warning score modified by serum lactate level, NEWS-L score, was comparable to PSI and CURB-65, for predicting inpatient mortality among adult CAP patients. (C) 2015 Elsevier Inc. All rights reserved.
URI
https://www.sciencedirect.com/science/article/pii/S0735675715011237?via%3Dihubhttp://hdl.handle.net/20.500.11754/40925
ISSN
0735-6757; 1532-8171
DOI
10.1016/j.ajem.2015.12.067
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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