NEW2 scale in early warning predicts SEPSIS

The article is written by Specialist Doctor II Pham Tien Ngoc - Emergency Doctor, Emergency Department - Vinmec Central Park International General Hospital

The qSOFA score is used as an effective tool in sepsis screening in non-ICU wards. In many studies qSOFA has low sensitivity, relative to specificity, and does not appear to be suitable as a screening tool for sepsis, so the scale (NEWS, MEWS) is used in Asian countries. Europe since 2017 as a fairly accurate forecasting tool in emergency departments and common wards.

Sepsis is defined as life-threatening organ failure due to dysregulation of the host response to infection. Organ failure was defined as an acute change with a total SOFA score ≥ 2, a consequence of sepsis. When SOFA score ≥ 2, reflects 10% increased risk of death in sepsis.
Sepsis is the primary cause of death in infections. Sepsis is a syndrome, which differs from infection in that: the response (of the host) to infection is uncontrolled and organ dysfunction is present. Organ dysfunction in NTH can be subtle. The clinical and biological phenotype of NTH can vary with the underlying disease, drugs, and therapeutic interventions. Some infections may have only organ dysfunction, with no uncontrolled systemic response.
Since 1990, it has been found that patients, before cardiac arrest, often have a change in some vital signs, a combination of 10 different factors with different cut-off points. About 16 years later, the early warning scale was only introduced, in 2012 the NEWS scale was introduced, NEWS 2 was born in 2017 and has created a common voice in European countries as a tool to predict sepsis early. .
In a number of new studies, NEWS2 is a clinical tool that is superior to qSOFA and SIRS in screening for early sepsis when there is no test to evaluate, or there is no initial organ damage.

NEWS 2 score includes 6 parameters as follows, and the advantage is that it can monitor hypercapnia in COPD patients when there is a change in blood oxygen and increased carbon dioxide: respiratory rate, saturation capillary oxygen, blood pressure, pulse, temperature, and consciousness.
Each parameter will be scored based on the corresponding change. NEWS2 scoreboard has 6 parameters, but no need to remember, when applying the practice, you can download the app (MD+ CALC) on your phone and it's easy to use, very flexible.

When NEWS2 score ≥ 5, need assessment protocol to closely monitor clinical status every hour, should patients be screened for sepsis?
NEWS2 ≥ 5, hospitalization and mortality rate is 23% compared to (NEWS2) <5 points is 8%. Mortality rate within 30 days increased to 11.3% compared to 5.5% when NEWS2 increased more than 5 points.

Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, a system of modern equipment and technology. The hospital provides comprehensive and professional medical examination, consultation and treatment services, with a civilized, polite, safe and sterile medical examination and treatment space.