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. 2019 Jul 29;8(8):1128.
doi: 10.3390/jcm8081128.

NEWS2 is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department

Lisa Mellhammar  1   2 , Adam Linder  3   4 , Jonas Tverring  3   5 , Bertil Christensson  3   4 , John H Boyd  6 , Parham Sendi  7   8 , Per Åkesson  3   4 , Fredrik Kahn  3   4
Affiliations

NEWS2 is Superior to qSOFA in Detecting Sepsis with Organ Dysfunction in the Emergency Department

Lisa Mellhammar et al. J Clin Med. .

Abstract

Early administration of antibiotics is associated with better survival in sepsis, thus screening and early detection for sepsis is of clinical importance. Current risk stratification scores used for bedside detection of sepsis, for example Quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2), are primarily validated for death and intensive care. The primary aim of this study was to compare the diagnostic accuracy of qSOFA and NEWS2 for a composite outcome of sepsis with organ dysfunction, infection-related mortality within <72 h, or intensive care due to an infection. Retrospective analysis of data from two prospective, observational, multicentre, convenience trials of sepsis biomarkers at emergency departments were performed. Cohort A consisted of 526 patients with a diagnosed infection, 288 with the composite outcome. Cohort B consisted of 645 patients, of whom 269 had a diagnosed infection and 191 experienced the composite outcome. In Cohort A and B, NEWS2 had significantly higher area under receiver operating characteristic curve (AUC), 0.80 (95% CI 0.75-0.83) and 0.70 (95% CI 0.65-0.74), than qSOFA, AUC 0.70 (95% CI 0.66-0.75) and 0.62 (95% CI 0.57-0.67) p < 0.01 and, p = 0.02, respectively for the composite outcome. NEWS2 was superior to qSOFA for screening for sepsis with organ dysfunction, infection-related mortality or intensive care due to an infection both among infected patients and among undifferentiated patients at emergency departments.

Keywords: NEWS2; early warning score; qSOFA; sepsis; validation studies.

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Conflict of interest statement

Bertil Christensson, Per Åkesson and Adam Linder are listed as inventors on a patent on the use of HBP as a diagnostic tool in sepsis filed by Hansa Medical AB. All other authors have declared no relevant conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart. Cohort A, patients with suspected infection and one of systemic inflammatory response syndrome (SIRS) criteria, or self-reported fever or chills. Cohort B, patients with one of the following parameters: respiratory rate > 25, heart rate > 120, altered mental awareness, SBP < 100 mmHg, SaO2 < 90%, or <93% if ongoing treatment with oxygen. qSOFA (Quick Sequential Organ Failure Assessment). NEWS2 (National Early Warning Score 2). HBP (heparin binding protein).
See this image and copyright information in PMC

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