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

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.