Combination of the National Early Warning Score (NEWS) and inflammatory biomarkers for early risk stratification in emergency department patients: results of a multi-national, observational study

Objectives: The National Early Warning Score (NEWS) helps to estimate mortality risk in emergency department (ED) patients. This study aimed to investigate whether the prognostic value of the NEWS at ED admission could be further improved by adding inflammatory blood markers (i.e. white blood cell count (WBC), procalcitonin (PCT), and MR-ProAdrenomedullin (MR-proADM). Design: Secondary analysis of a multinational, observational study. (TRIAGE study, March 2013 to October 2014) Setting: Three tertiary care centers in France, Switzerland, and the USA. Participants: A total of 1303 adult medical patients with complete NEWS data seeking ED care were included in the final analysis. NEWS was calculated retrospectively based on admission data. Main outcome measures: The primary outcome was all-cause 30-day mortality. Secondary outcome was ICU admission. We used multivariate regression analyses to investigate associations of NEWS and blood markers with outcomes and area under the receiver o...研究目的：国家早期预警评分（National Early Warning Score, NEWS）可用于评估急诊室（emergency department, ED）患者的死亡风险。本研究旨在探讨在急诊入院时应用的NEWS基础上，联合炎性血液标志物（即白细胞计数（white blood cell count, WBC）、降钙素原（procalcitonin, PCT）及肾上腺髓质素原（MR-ProAdrenomedullin, MR-proADM））是否可进一步提升其预后评估价值。 研究设计：一项多国观察性研究的二次分析（TRIAGE研究，2013年3月至2014年10月）。 研究场景：法国、瑞士与美国的3家三级医疗中心。 研究对象：最终分析共纳入1303名具备完整NEWS数据的成年内科急诊就诊患者，NEWS基于患者入院数据回顾性计算得到。 主要结局指标：主要结局为全因30天死亡率；次要结局为重症监护病房（intensive care unit, ICU）收治情况。本研究采用多因素回归分析，探究NEWS及血液标志物与结局的关联及受试者工作特征曲线下面积（原文此处截断为area under the receiver o...）。