National Early Warning Score (NEWS) at ICU discharge can predict early clinical deterioration after ICU transfer

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Abstract

Objective:

This study aims to determine the ability of the National Early Warning Score at ICU discharge (NEWSdc) to predict the development of clinical deterioration within 24 h.

Methods:

A prospective observational study was conducted. The NEWS was immediately recorded before discharge (NEWSdc). The development of early clinical deterioration was defined as acute respiratory failure or circulatory shock within 24 h of ICU discharge. The discrimination of NEWSdc and the best cut off value of NEWSdc to predict the early clinical deterioration was determined.

Results:

Data were collected from 440 patients. The incidence of early clinical deterioration after ICU discharge was 14.8%. NEWSdc was an independent predictor for early clinical deterioration after ICU discharge (OR 2.54; 95% CI 1.98–3.26; P < 0.001). The AUROC of NEWSdc was 0.92 ± 0.01 (95% CI 0.89–0.94, P < 0.001). A NEWSdc > 7 showed a sensitivity of 93.6% and a specificity of 82.2% to detect an early clinical deterioration after ICU discharge.

Conclusion:

Among critically ill patients who were discharged from ICU, a NEWSdc > 7 showed the best sensitivity and specificity to detect early clinical deterioration 24 h after ICU discharge.

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