Research Article

Prognostic Accuracy of the Quick Sequential Organ Failure Assessment Score and National Early Warning Scores in mortality rate of the Non-Traumatic Patients


Background: The current study aimed to evaluate the predictive value of mortality in patients admitted to the Intensive Care Unit (ICU) through the emergency department and based on Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS) and NEWS2 criteria.
Methods: In this cross-sectional study, all patients referred to the emergency department with a need of admission to ICU for any reason, were evaluated. Demographic data such as age and sex were recorded for data collection. Also, the main diagnosis, length of stay and hospitalization outcome along with data related to qSOFA, NEWS and NEWS2 indices were included in the researcher's checklist.
Results: Of 89 included patients, 52 (58.4%) were male and 37 (41.6%) were female, with mean age of 60.25±20.8. Our findings indicated that qSOFA is a good predictor for mortality in non-traumatic patients so that qSOFA has 48% sensitivity and 100% specificity in the diagnosis of mortality in non-trauma patients. NEWS also has a sensitivity of 72% and a specificity of 71.4% in the diagnosis of non-traumatic mortality. And NEWS2 has 72% sensitivity and 78.6% specificity in non-traumatic mortality diagnosis.
Conclusion: Our findings suggested that the sensitivity and specificity of qSOFA, NEWS and NEWS2 in predicting the mortality of non-traumatic patients who were admitted in emergency departments and hospitalized in ICU, are high and reliablen.

[1] Kane B, Decalmer S, Murphy P, Turkington P, O’Driscoll B. S29 The proposed National Early Warning System (NEWS) could be hazardous for patients who are at risk of hypercapnic respiratory failure. Thorax. 2012; 67(Suppl 2):A16-A7.
[2] Excellence NIfC. Acutely ill adults in hospital: recognising and responding to deterioration. NICE Guidelines. 2007:1-30.
[3] Teasdale GM. National early warning score (NEWS) is not suitable for all patients. Bmj. 2012; 345:e5875.
[4] Dawes T, Cheek E, Bewick V, Dennis M, Duckitt R, Walker J, et al. Introduction of an electronic physiological early warning system: effects on mortality and length of stay. Br J Anaesth. 2014; 113(4):603-9.
[5] Silcock DJ, Corfield AR, Gowens PA, Rooney KD. Validation of the National Early Warning Score in the prehospital setting. Resuscitation. 2015; 89:31-5.
[6] Churpek MM, Snyder A, Han X, Sokol S, Pettit N, Howell MD, et al. Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit. Am J Respir Crit Care Med. 2017; 195(7):906-11.
[7] O'Driscoll BR, Howard LS, Earis J, Mak V. British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Respir Res. 2017;4(1):e000170.
[8] Eccles SR, Subbe C, Hancock D, Thomson N. CREWS: improving specificity whilst maintaining sensitivity of the National Early Warning Score in patients with chronic hypoxaemia. Resuscitation. 2014; 85(1):109-11.
[9] Physicians RCo. National early warning score (NEWS) 2. Standardising the assessment of acute-illness severity in the NHS. 2017.
[10] Pimentel MA, Redfern OC, Gerry S, Collins GS, Malycha J, Prytherch D, et al. A comparison of the ability of the National Early Warning Score and the National Early Warning Score 2 to identify patients at risk of in-hospital mortality: a multi-centre database study. Resuscitation. 2019; 134:147-56.
[11] Singer AJ, Ng J, Thode Jr HC, Spiegel R, Weingart S. Quick SOFA scores predict mortality in adult emergency department patients with and without suspected infection. Ann Emerg Med. 2017; 69(4):475-9.
[12] Park HK, Kim WY, Kim MC, Jung W, Ko BS. Quick sequential organ failure assessment compared to systemic inflammatory response syndrome for predicting sepsis in emergency department. J Crit Care. 2017; 42:12-7.
[13] Finkelsztein EJ, Jones DS, Ma KC, Pabón MA, Delgado T, Nakahira K, et al. Comparison of qSOFA and SIRS for predicting adverse outcomes of patients with suspicion of sepsis outside the intensive care unit. Crit Care. 2017; 21(1):73.
[14] Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017; 43(3):304-77.
[15] Giamarellos-Bourboulis EJ, Tsaganos T, Tsangaris I, Lada M, Routsi C, Sinapidis D, et al. Validation of the new Sepsis-3 definitions: proposal for improvement in early risk identification. Clinical Microbiology and Infection. 2017; 23(2):104-9.
[16] Boillat-Blanco N, Mbarack Z, Samaka J, Mlaganile T, Mamin A, Genton B, et al. Prognostic value of quickSOFA as a predictor of 28-day mortality among febrile adult patients presenting to emergency departments in Dar es Salaam, Tanzania. PloS one. 2018; 13(6):e0197982.
[17] Patterson C, Maclean F, Bell C, Mukherjee E, Bryan L, Woodcock T, et al. Early warning systems in the UK: variation in content and implementation strategy has implications for a NHS early warning system. Clin Med. 2011; 11(5):424-7.
[18] Smith GB, Prytherch DR, Meredith P, Schmidt PE, Featherstone PI. The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death. Resuscitation. 2013; 84(4):465-70.
[19] Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med. 2016; 193(3):259-72.
IssueVol 7 No 1 (2021): Winter QRcode
SectionResearch Article(s)
Quick sequential organ failure assessment National early warning National early warning scores Non-Traumatic Mortality

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Shahsavarinia K, Mahmoud Alilou A, Mahmoud Alilou S, Mahmoud Alilou P, Gharekhani A, Gilani N. Prognostic Accuracy of the Quick Sequential Organ Failure Assessment Score and National Early Warning Scores in mortality rate of the Non-Traumatic Patients. Arch Anesth & Crit Care. 7(1):7-1.