The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPD
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are the most devastating events in the course of the disease. Our aim was to investigate the value of early warning scoring systems: National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) in AECOPD. This is a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-01-01
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| Series: | Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine |
| Online Access: | https://doi.org/10.1177/11795484231152305 |
| _version_ | 1827936128936706048 |
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| author | Christina Triantafyllidou Petros Effraimidis Konstantinos Vougas Jonas Agholme Mirjam Schimanke Karin Cederquist |
| author_facet | Christina Triantafyllidou Petros Effraimidis Konstantinos Vougas Jonas Agholme Mirjam Schimanke Karin Cederquist |
| author_sort | Christina Triantafyllidou |
| collection | DOAJ |
| description | Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are the most devastating events in the course of the disease. Our aim was to investigate the value of early warning scoring systems: National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) in AECOPD. This is a prospective observational study of patients with AECOPD who were admitted at hospital. The NEWS and MEWS scores were registered at admission (NEWS-d1, MEWS-d1) and on the second day (NEWS-d2, MEWS-d2). A nasopharyngeal and sputum sample was taken for culture. Follow-up was done at 3 and 6 months after hospitalization. Any possible correlations between NEWS and MEWS and other parameters of COPD were explored. A cohort of 64 patients were included. In-hospital mortality was 4.7% while total mortality at 6 months was 26%. We did not find any significant correlation between in-hospital mortality and any of the scores but we could show a higher mortality and more frequent AECOPD at 6 months of follow-up for those with higher NEWS-d2. NEWS-d2 was associated with higher pCO 2 at presentation and a more frequent use of NIV. Higher NEWS-d1 and NEWS-d2 were predictive of a longer hospital stay. The presence of pathogens in the nasopharyngeal sample was related with a higher reduction of both scores on the second day. We therefore support the superiority of NEWS in the evaluation of hospitalized patients with AECOPD. A remaining high NEWS at the second day of hospital stay signals a high risk of hypercapnia and need of NIV but also higher mortality and more frequent exacerbations at 6 months after AECOPD. |
| first_indexed | 2024-03-13T08:05:42Z |
| format | Article |
| id | doaj.art-e05eff401594410cb61fcb749de7e4a7 |
| institution | Directory Open Access Journal |
| issn | 1179-5484 |
| language | English |
| last_indexed | 2024-03-13T08:05:42Z |
| publishDate | 2023-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine |
| spelling | doaj.art-e05eff401594410cb61fcb749de7e4a72023-06-01T07:03:34ZengSAGE PublishingClinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine1179-54842023-01-011710.1177/11795484231152305The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPDChristina Triantafyllidou0Petros Effraimidis1Konstantinos Vougas2Jonas Agholme3Mirjam Schimanke4Karin Cederquist5 Department of Internal Medicine, Section of Pulmonary Medicine, Vrinnevi Hospital, Norrköping, Sweden Department of Internal Medicine, Section of Pulmonary Medicine, Vrinnevi Hospital, Norrköping, Sweden Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Department of Internal Medicine, Section of Pulmonary Medicine, Vrinnevi Hospital, Norrköping, Sweden Department of Internal Medicine, Section of Pulmonary Medicine, Vrinnevi Hospital, Norrköping, Sweden Department of Internal Medicine, Section of Pulmonary Medicine, Vrinnevi Hospital, Norrköping, SwedenAcute exacerbations of chronic obstructive pulmonary disease (AECOPD) are the most devastating events in the course of the disease. Our aim was to investigate the value of early warning scoring systems: National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) in AECOPD. This is a prospective observational study of patients with AECOPD who were admitted at hospital. The NEWS and MEWS scores were registered at admission (NEWS-d1, MEWS-d1) and on the second day (NEWS-d2, MEWS-d2). A nasopharyngeal and sputum sample was taken for culture. Follow-up was done at 3 and 6 months after hospitalization. Any possible correlations between NEWS and MEWS and other parameters of COPD were explored. A cohort of 64 patients were included. In-hospital mortality was 4.7% while total mortality at 6 months was 26%. We did not find any significant correlation between in-hospital mortality and any of the scores but we could show a higher mortality and more frequent AECOPD at 6 months of follow-up for those with higher NEWS-d2. NEWS-d2 was associated with higher pCO 2 at presentation and a more frequent use of NIV. Higher NEWS-d1 and NEWS-d2 were predictive of a longer hospital stay. The presence of pathogens in the nasopharyngeal sample was related with a higher reduction of both scores on the second day. We therefore support the superiority of NEWS in the evaluation of hospitalized patients with AECOPD. A remaining high NEWS at the second day of hospital stay signals a high risk of hypercapnia and need of NIV but also higher mortality and more frequent exacerbations at 6 months after AECOPD.https://doi.org/10.1177/11795484231152305 |
| spellingShingle | Christina Triantafyllidou Petros Effraimidis Konstantinos Vougas Jonas Agholme Mirjam Schimanke Karin Cederquist The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPD Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine |
| title | The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPD |
| title_full | The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPD |
| title_fullStr | The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPD |
| title_full_unstemmed | The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPD |
| title_short | The Role of Early Warning Scoring Systems NEWS and MEWS in the Acute Exacerbation of COPD |
| title_sort | role of early warning scoring systems news and mews in the acute exacerbation of copd |
| url | https://doi.org/10.1177/11795484231152305 |
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