Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Comparing the Prehospital News With In-Hospital Esi in Predicting 30-Day Severe Outcomes in Emergency Patients Publisher Pubmed



Saberian P1, 2 ; Abdollahi A1, 2 ; Hasanisharamin P3 ; Modaber M3 ; Karimialavijeh E1, 4
Authors
Show Affiliations
Authors Affiliations
  1. 1. Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Anesthesiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Tehran Emergency Medical Service Center, Tehran, Iran
  4. 4. Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Emergency Medicine Published:2022


Abstract

Background: In Iran, the emergency departments (EDs) have largely adopted the emergency severity index (ESI) to prioritize the emergency patients, however emergency medical services (EMS) mainly triage the patients based on the paramedics’ gestalt. The National Early Warning Score (NEWS) is a recommended prehospital triage in the UK. We aimed to compare prehospital NEWS and ED ESI for predicting severe outcomes in emergency patients. Methods: An observational study was conducted in a university-affiliated ED between January and April 2021. Adult patients who arrived in the ED by EMS were included. EMS providers calculated the patients' NEWS upon arriving on the scene using an Android NEWS application. In the ED, triage nurses utilized the ESI algorithm to prioritize patients with higher clinical risk. Then, Research nurses recorded patients' 30-day severe outcomes (death or ICU admission). Finally, The prognostic properties of ESI and NEWS were evaluated. Results: One thousand forty-eight cases were included in the final analysis, of which 29 (2.7%) patients experienced severe outcomes. The difference between the prehospital NEWS and ED ESI in predicting severe outcomes was not statistically significant (AUC = 0.825, 95% CI: 0.74–0.91 and 0.897, 95% CI, 0.83–0.95, for prehospital NEWS and ESI, respectively). Conclusion: Our findings indicated that prehospital NEWS compares favorably with ED ESI in predicting 30-day severe outcomes in emergency patients. © 2022, The Author(s).