Association between the national early warning score and the mortality among neuroemergency patients

Objective: The objective of this study was to determine the association between the National Early Warning Score (NEWS), a standardized tool for assessing acute illness severity, and the mortality of the neuroemergency cases seen in the emergency room (ER). Subjects and Methods: This retrospective cohort study was conducted from July to December 2017 in the ER at the Dr. Cipto Mangunkusumo Hospital in Jakarta, Indonesia. All of the ER patients examined by the neurology team were included in this study. The demographic, NEWS, Glasgow Coma Scale, and mortality data were collected from the medical record. Results: Of the 1526 patients admitted, the NEWS data were available for 907 of the cases (59.4%). Of the 1421 well-documented patients, 143 died. There was a significant relationship between the NEWS category and the mortality risk (P < 0.001). Going from the low to the medium and from the medium to the high NEWS categories dramatically increased the mortality risk, with relative risks of 20.238 (8.808-46.501) and 6.466 (2.466-16.957), respectively. The NEWS cutoff point for determining mortality in this study was 6, with a sensitivity of 73.5% and specificity of 80.1%. Conclusion: The NEWS category was significantly related to the mortality risk of neuroemergency patients; therefore, it should be implemented routinely to help predict the mortality in the ER.