Using the National Early Warning Score 2 with an adjusted target saturation among patients admitted to the hospital for COPD exacerbations reduces alert frequency without a notable difference in mortality when compared with unadjusted National Early Warning Score 2, a recent study suggests.
“Patients admitted with COPD exacerbations have a modest in-hospital mortality rate (3.9%-4.3%), but frequently trigger alerts on the National Early Warning Scale (NEWS),” the researchers wrote. “This can place a substantial burden on health care professionals, create complacency and promote excess oxygen use in those who are at particular risk of its harmful effects.”
Researchers examined 2,645 patients with COPD exacerbations admitted to one of six U.K. hospitals. All patients were required to meet spirometry criteria for COPD, and were analyzed with NEWS2, NEWS2 with adjusted target saturations to 88% to 92% for patients with hypercapnic respiratory failure and NEWS scores. Patients were also risk-stratified based on dyspnea, eosinopenia, consolidation, acidemia and atrial fibrillation (DECAF) scores. Alert appropriateness and frequency were measured for all NEWS assessments, with prognostic performance compared using the area under the receiver operating characteristic curve (AUROC).