COPD exacerbations: 2 much NEWS?

• Published in: Thorax Vol. 74; no. 10; pp. 929 - 930
• Main Authors: Suh, Eui-Sik, Sage, Beth
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Thoracic Society 01.10.2019; BMJ Publishing Group LTD
• Subjects: Audits; Biomarkers; Chronic obstructive pulmonary disease; Clinical medicine; COPD epidemiology; COPD exacerbations; critical care; Disease Progression; Early Warning Score; Editorial; Humans; Mortality; Patients; Physicians; Physiology; Pulmonary Disease, Chronic Obstructive; Thorax; United Kingdom > UK; COPD epidemiology; critical care; COPD exacerbations
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thoraxjnl-2019-213788

Several such tools have been developed to predict in-hospital mortality, of which the Dyspnoea, Eosinopenia, Consolidation, Acidaemia and atrial Fibrillation (DECAF) score has received the greatest attention2 3 indeed, the 2014 UK National COPD Audit report recommended the DECAF score for all patients hospitalised for ECOPD, in part to enable adjustment for mortality risk in a mixed cohort. The study incorporated the presence of new confusion, unlike recent studies that have evaluated NEWS2,7 8 and demonstrated that this addition improved its ability to detect in-hospital mortality. Furthermore, the authors make a convincing case for the superiority of the DECAF score in assessing in-hospital mortality risk and have included their comparison with NEWS2 on the basis that the latter is used to adjust for case mix in the National COPD Audit. [...]the authors consider only the physiological data at the beginning of the hospital admission for their evaluation of NEWS, NEWS2 and NEWS2ALL COPD, whereas in practice these scores would be recorded several times a day throughout the inpatient stay and may reach a maximum value later on in the hospital stay.