The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis

<strong>Objectives</strong> To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive c...

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Main Authors: Malycha, J, Farajidavar, N, Pimentel, M, Redfern, O, Clifton, D, Tarassenko, L, Meredith, P, Prytherch, D, Ludbrook, G, Young, J, Watkinson, P
Format: Journal article
Language:English
Published: Elsevier 2019
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author Malycha, J
Farajidavar, N
Pimentel, M
Redfern, O
Clifton, D
Tarassenko, L
Meredith, P
Prytherch, D
Ludbrook, G
Young, J
Watkinson, P
author_facet Malycha, J
Farajidavar, N
Pimentel, M
Redfern, O
Clifton, D
Tarassenko, L
Meredith, P
Prytherch, D
Ludbrook, G
Young, J
Watkinson, P
author_sort Malycha, J
collection OXFORD
description <strong>Objectives</strong> To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission. <br/><br/> <strong>Methods</strong> A multi-centre, retrospective, observational cohort study was carried out in five hospitals from two UK NHS Trusts. Adult admissions with at least one complete set of vital sign observations recorded electronically were eligible. The primary outcome measure was an ‘adverse event’ which comprised either in-hospital death or unplanned ICU admission. Discrimination was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC). <br/><br/> <strong>Results</strong> A cohort of 83,304 patients from a total of 271,363 adult admissions were prescribed oxygen. In this cohort, NEWS-FiO2 (AUROC 0.823, 95% CI 0.819–0.824) outperformed NEWS (AUORC 0.811, 95% CI 0.809–0.814) when predicting in-hospital death or unplanned ICU admission within 24 h of a complete set of vital sign observations. <br/><br/> <strong>Conclusions</strong> NEWS-FiO2 generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.
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spelling oxford-uuid:7d80c12c-b535-468f-b146-e806852ed2372022-03-26T21:04:07ZThe effect of fractional inspired oxygen concentration on early warning score performance: a database analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7d80c12c-b535-468f-b146-e806852ed237EnglishSymplectic Elements at OxfordElsevier2019Malycha, JFarajidavar, NPimentel, MRedfern, OClifton, DTarassenko, LMeredith, PPrytherch, DLudbrook, GYoung, JWatkinson, P<strong>Objectives</strong> To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission. <br/><br/> <strong>Methods</strong> A multi-centre, retrospective, observational cohort study was carried out in five hospitals from two UK NHS Trusts. Adult admissions with at least one complete set of vital sign observations recorded electronically were eligible. The primary outcome measure was an ‘adverse event’ which comprised either in-hospital death or unplanned ICU admission. Discrimination was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC). <br/><br/> <strong>Results</strong> A cohort of 83,304 patients from a total of 271,363 adult admissions were prescribed oxygen. In this cohort, NEWS-FiO2 (AUROC 0.823, 95% CI 0.819–0.824) outperformed NEWS (AUORC 0.811, 95% CI 0.809–0.814) when predicting in-hospital death or unplanned ICU admission within 24 h of a complete set of vital sign observations. <br/><br/> <strong>Conclusions</strong> NEWS-FiO2 generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.
spellingShingle Malycha, J
Farajidavar, N
Pimentel, M
Redfern, O
Clifton, D
Tarassenko, L
Meredith, P
Prytherch, D
Ludbrook, G
Young, J
Watkinson, P
The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis
title The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis
title_full The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis
title_fullStr The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis
title_full_unstemmed The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis
title_short The effect of fractional inspired oxygen concentration on early warning score performance: a database analysis
title_sort effect of fractional inspired oxygen concentration on early warning score performance a database analysis
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