Article Figures & Data
Figures
- Figure 1. Flow diagram demonstrating study population.
- Figure 2. Proportion of total primary care referrals with a NEWS recorded at the point of referral across the evaluation period.
- Figure 3. Adverse outcomes stratified by source of NEWS and risk group
Tables
Referrals from primary care Demographic NEWS recorded by ambulance, % (n) (n = 1 126 ) NEWS recorded at point of referral, % (n) (n = 2252) Mean age, years (SD) 76 (15) 65 (21) Frailty 20.8 (234) 10.6 (239) Dementia 15.2 (171) 7.5 (169) ReSPECT form 29.0 (327) 17.9 (403) Receiving chemotherapy 3.2 (36) 2.5 (56) Receiving specialist palliative care 13.1 (148) 7.5 (169) Death at5 days 3.6 (41) 1.9 (43) Death or critical care at 5 days 5.2 (59) 3.2 (72) Death at30 days 11.7 (132) 5.8 (131) Death or critical care at 30 days 13.5 (152) 7.3 (164) ReSPECT form = Recommended Summary Plan for Emergency Treatment form.
5 day outcome 30 day outcome NEWS ≥5 NEWS ≥7 NEWS ≥5 NEWS ≥7 Death (95% CI) Death or critical care admission (95% CI) Death (95% CI) Death or critical care admission (95% CI) Death (95% CI) Death or critical care admission (95% CI) Death (95% CI) Death or critical care admission (95% CI) NEWS recorded by GP Sensitivity 49%(33-65) 38%(31-47) 21%(10-36) 25%(18-33) 37%(29-46) 37%(30-45) 23%(16-31) 24%(18-32) Specificity 83%(81-84) 84%(82-85) 93%(91-94) 94%(92-95) 83%(82-85) 84%(82-85) 93%(92-94) 94%(92-95) Positive predictive value 5%(3-8) 15%(12-19) 5%(2-10) 22%(16-29) 12%(9-16) 15%(12-19) 17%(12-24) 23%(17-30) Negative predictive value 99%(98-99) 95%(94-96) 98%(98-99) 94%(93-95) 96%(95-96) 94%(93-95) 95%(94-96) 94%(93-95) Positive likelihood ratio 2.8(2.1–3.9) 2.3(1.9–2.9) 2.8(1.5–5.1) 3.9(2.8–5.3) 2.2(1.8–2.8) 2.3(1.8–2.8) 3.4(2.4–4.8) 3.8(2.8–5.2) Negative likelihood ratio 0.6(0.5–0.8) 0.7(0.7–0.8) 0.9(0.7–1.0) 0.8(0.7–0.9) 0.8(0.7–0.9) 0.8(0.7–0.9) 0.8(0.8–0.9) 0.8(0.7–0.9) NEWS recorded by ambulance Sensitivity 62%(46-77) 53%(45-62) 42%(27-59) 32%(24-40) 54%(45-62) 53%(45-61) 24%(18-30) 31%(24-39) Specificity 67%(64-70) 69%(66-72) 85%(83-87) 86%(84-88) 69%(66-72) 69%(66-72) 86%(84-88) 86%(84-88) Positive predictive value 7%(4-10) 21%(17-25) 9%(6-15) 26%(20-33) 19%(15-23) 21%(17-26) 24%(18-30) 26%(20-33) Negative predictive value 98%(97-99) 91%(88-93) 98%(96-98) 89%(87%–91%) 92%(90-94) 90%(88-92) 86%(84-88) 89%(87-91) Positive likelihood ratio 1.9(1.5–2.5) 1.7(1.4–2.1) 2.8(1.9–4.1) 2.3(1.7–3.1) 1.7(1.4–2.1) 1.7(1.5–2.1) 1.7(1.3–2.3) 2.2(1.7–3.0) Negative likelihood ratio 0.6(0.4–0.8) 0.7(0.6–0.8) 0.7(0.5–0.9) 0.8(0.7–0.9) 0.7(0.6–0.8) 0.7(0.6–0.8) 0.9(0.8–1.0) 0.8(0.7-.0.9) NEWS = national early warning scores.
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The prognostic value of national early warning scores (NEWS) during transfer of care from community settings to hospital: a retrospective service evaluation
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