NEWS 2 – too little evidence to implement?

• Published in: Clinical medicine (London, England) Vol. 18; no. 5; pp. 371 - 373
• Main Authors: Hodgson, Luke E, Congleton, Jo, Venn, Richard, Forni, Lui G, Roderick, Paul J
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-10-2018; Royal College of Physicians
• Subjects: Aged; Aged, 80 and over; Chronic obstructive pulmonary disease; Data analysis; Hospitals; Humans; Monitoring, Physiologic; Mortality; National Early Warning Score 2; Original Research; Oxygen - blood; Patients; Physicians; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - mortality; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiratory failure; Retrospective Studies; Severity of Illness Index; United Kingdom - epidemiology; Validation studies; validation study; Vital signs; United Kingdom; Chronic obstructive pulmonary disease; National Early Warning Score 2; validation study
• ISSN: 1470-2118; 1473-4893
• DOI: 10.7861/clinmedicine.18-5-371

The Royal College of Physicians (RCP) recently published the National Early Warning Score 2 (NEWS2), aiming to improve safety for patients with hypercapnic respiratory failure by suggesting a separate oxygen saturation (SpO2) parameter scoring system for such patients. A previously published study of patients (n=2,361 admissions) with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) demonstrated alternative scoring systems at admission did not outperform the original NEWS. Applying NEWS2 SpO2 parameters to this previously described cohort would have resulted in 44% (n=27/62) of patients who scored ≥7 points on the original NEWS and subsequently died being placed in a lower call-out threshold. NEWS2 loses the benefits of a unified, standardised scoring system and we suggest prospective research in this area before applying this adjustment.