Validation of modified early warning score using serum lactate level in community-acquired pneumonia patients. The National Early Warning Score–Lactate score - 17/03/16
, Jae Baek Lee, MD, PhD a, Youngho Jin, MD, PhD a, Jaechol Yoon, MD a, Boyoung Park, MD bAbstract |
Study objective |
The aim of this study was to investigate the prognostic prediction power of a newly introduced early warning score modified by serum lactate level, the National Early Warning Score–Lactate (NEWS-L) score, among community-acquired pneumonia (CAP) patients. We also compared the NEWS-L score with the pneumonia severity index (PSI) and CURB-65.
Methods |
We designed a retrospective observational study and collected data on confirmed adult CAP patients who visited the study hospital between October 2013 and September 2014. Variables relevant to, the NEWS-L score, PSI, and CURB-65 were extracted from electronic medical records. Survival status at hospital discharge was determined in the same manner. The NEWS-L score was calculated as NEWS-L=NEWS+serum lactate level (mmol/L). The NEWS-L was divided into quartiles. The ability to predict mortality was assessed through area under the receiver operating characteristic curve analysis and calibration analysis.
Results |
A total of 553 patients were enrolled, and the inpatient mortality rate was 10.8% (n=60). Mortality rates increased incrementally in conjunction with the NEWS-L quartiles: first quartile, 2.2%; second quartile, 7.9%; third quartile, 9.6%; and fourth quartile, 23.9%. The area under the receiver operating characteristic curve of the NEWS-L score was 0.73 (95% confidence interval [CI], 0.66-0.80), which showed no significant difference from that of the PSI (0.68; 95% CI, 0.61-0.76; P=.28) and CURB-65 (0.66; 95% CI, 0.59-0.73; P=.06).
Conclusions |
The newly introduced early warning score modified by serum lactate level, NEWS-L score, was comparable to PSI and CURB-65, for predicting inpatient mortality among adult CAP patients.
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| ☆ | Declaration of interest: The authors report no conflicts of interest. The authors are responsible for the content and writing of the paper. |
| ☆☆ | Conflict of interests: None. |
| ★ | Funding and support: None. |
| ★★ | Author contributions: S.J. and T.J. designed this study. S.J. supervised the overall data collection process, had full access to all the data in the study, and takes responsibility for the integrity of the data. B.P. conducted the data analysis. S.J. wrote the initial draft of the article. All authors provided substantial review and feedback on the final version of the article. T.J. takes responsibility for the paper as a whole. |
| ☆☆☆ | All authors have read and approved the submitted manuscript. This manuscript has not been submitted or published elsewhere in whole or in part, except as an abstract (if relevant). |
Vol 34 - N° 3
P. 536-541 - mars 2016 Retour au numéro
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