Predictive and Prognostic Importance of National Early Warning Score 2 (NEWS2) in Emergency Room Patients

Abstract

Introduction The National Early Warning Score 2 (NEWS2), a modified version of its predecessor NEWS, is a screening tool developed by the Royal College of Physicians and serves as a stratification tool/scale that classifies patients based on six physiological parameters. Despite being widely recognized for its excellent accuracy, there is limited evidence regarding its application within the Indian population and its role in resource allocation to enhance patient care. This study aims to evaluate the predictive accuracy of NEWS2 in determining mortality among Indian patients, aiding in proper risk stratification and improving the quality of care.  Materials and methods This prospective observational study was conducted over six months in the emergency department of a South Indian tertiary care hospital. Out of 150 patients screened, 101 (n = 101) were included after obtaining informed consent and meeting the inclusion criteria. The study aimed to assess the predictive accuracy of NEWS2 and analyze the distribution of its individual physiological parameters. Results The study showed a significant difference in NEWS2 scores between survivors (n = 87, mean 4.36, SD 2.698) and non-survivors (n = 14, mean 13.14, SD 1.406), highlighting its potential as a valuable tool for risk stratification. Of the 101 patients, 86.1% (n = 87) survived and 13.9% (n = 14) died. Survivors (n = 87) had a lower mean NEWS2 score of 4.36 ± 2.698, whereas non-survivors (n = 14) had a significantly higher mean score of 13.14 ± 1.406. Conclusion Our findings demonstrate that higher NEWS2 scores at admission are strongly correlated with mortality rates. These results validate NEWS2's effectiveness in identifying patients at risk of deterioration, affirming its role as a critical tool for early intervention in emergency care.