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National Early Warning Score-2 for Identification of Patients with Intermediate-High-Risk Pulmonary Embolism.
- Source :
-
Seminars in Thrombosis & Hemostasis . Oct2023, Vol. 49 Issue 7, p716-724. 9p. - Publication Year :
- 2023
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Abstract
- Consensus statements have proposed the use of the National Early Warning Score 2 (NEWS2) to identify stable patients with acute pulmonary embolism (PE) and an intermediate-high risk of adverse outcomes. We aimed to externally validate NEWS2 and compare it to another predictive score (Bova). Using NEWS2 (cutoff ≥5 and ≥7) and the Bova score (cutoff >4), we classified patients as intermediate-high risk (vs. non-intermediate-high risk), and we compared the test characteristics of these risk classification tools for a complicated course within 30 days after PE diagnosis. We also assessed the validity of NEWS2 for predicting a complicated course by adding the results of echocardiography and troponin testing to the model. Of the 848 enrolled patients, the NEWS2 score ≥5 classified 471 (55.5%) and the Bova score classified 37 (4.4%) as intermediate-high risk. NEWS2 had a significantly lower specificity for a 30-day complicated course than Bova (45.4 vs. 96.3%, respectively; p < 0.001). Using the higher score threshold (≥7), the NEWS2 classified 99 (11.7%) as intermediate-high risk, and the specificity was 88.9% (difference with Bova, 7.4%; p < 0.001). The proportion of patients with intermediate-high risk PE was 2.4% for the combination of a positive troponin testing and echocardiographic right ventricle dysfunction and a positive NEWS2 (score ≥7), while the specificity was 97.8% (difference with Bova, 1.5%; p = 0.07). Bova outperforms NEWS2 for predicting a complicated course among stable patients with PE. Addition of troponin testing and echocardiography improved the specificity of NEWS2, although it was not superior to Bova. ClinicalTrials.gov number : NCT02238639. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PULMONARY embolism
*EARLY warning score
Subjects
Details
- Language :
- English
- ISSN :
- 00946176
- Volume :
- 49
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Seminars in Thrombosis & Hemostasis
- Publication Type :
- Academic Journal
- Accession number :
- 172284905
- Full Text :
- https://doi.org/10.1055/s-0043-1769938