Affiliation:
1. University of Health Science, Gazi Yasargil Training and Research Hospital
2. University of Health Science, Istanbul Training and Research Hospital
Abstract
Objectives: Vitals are the most important parameters for assessing a patient’s status and the National Early Warning Score helps to assess vitals to predict how urgent a patient’s condition is. The perfusion index is the ratio of the pulsatile blood flow to the non-pulsatile/static blood flow in a patient’s peripheral tissue. We aimed to investigate the relationship between the National Early Warning Score and perfusion index in the courses and evaluate whether NEWS and PI are useful in predicting outcomes of older patients in an Emergency Department.
Method: In this prospective cross-sectional study, we evaluated non-traumatized older patients admitted to an Emergency Department. National Early Warning Score, perfusion index, and patients’ Emergency Department outcomes were recorded.
Results: A total of 967 patients (55% female, mean age=74.8) were enrolled. The initial National Early Warning Score of the patients had a significant, negative correlation with perfusion index (p < 0.001). Patients admitted to the hospital had higher National Early Warning Score and lower perfusion index values than those discharged (both p < 0.001). Patients admitted to an ICU had significantly higher National Early Warning Score and lower perfusion index values than those admitted to the medical floor (both p < 0.001).
Conclusion: The National Early Warning Score and the perfusion index are useful instruments to distinguish critically ill older patients in an Emergency Department.
Reference20 articles.
1. References
1. Cooper RJ, Schriger DL, Flaherty HL, Lin EJ, Hubbell KA. Effect of vital signs on triage decisions. Ann Emerg Med. 2002 Mar 1;39(3):223–32.
2. 2. Vergara P, Forero D, Bastidas A, Garcia JC, Blanco J, Azocar J, et al. Validation of the National Early Warning Score (NEWS)-2 for adults in the emergency department in a tertiary-level clinic in Colombia: Cohort study. Medicine (Baltimore) [Internet]. 2021 Oct 10 [cited 2022 Sep 4];100(40):e27325. Available from: /pmc/articles/PMC8500632/
3. 3. Royal College of Physicians. National Early Warning Score (NEWS): Standardising the assessment of acute-illness severity in the NHS. Report of a working party. Printed in Great Britain, London: RCP, 2012. URL: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news Accessed: 01.9.2022
4. 4. Hargrove J, Nguyen HB. Bench-to-bedside review: Outcome predictions for critically ill patients in the emergency department [Internet]. Vol. 9, Critical Care. BioMed Central; 2005 [cited 2020 Jun 5]. p. 376–83. Available from: http://ccforum.biomedcentral.com/articles/10.1186/cc3518
5. 5. Smith GB, Prytherch DR, Meredith P, Schmidt PE, Featherstone PI. The ability of the National Early Warning Score (NEWS) to discriminate against patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death. Resuscitation. 2013 Apr 1;84(4):465–70.