Evaluation Of The Newborn Early Warning Scores In Identifying Neonates At Risk For Clinical Deterioration

Objective: To validate the Newborn Early Warning Scores (NEWS) toidentify neonates at risk for clinical deterioration by retrospective analysis.Methods: A Newborn Early Warning Scores (NEWS) was designed todiscriminated between newborn infants who required transfer to theneonatal intensive care unit and those who did not require transfer.350patients admitted to neonate ward in CHCMU over a12-month period wereevaluated using the NEWS and the current pediatric early warning systemscores(PEWS) respectively. Clinical data were collected. The cutoff pointsof NEWS were identified by a receiver operating characteristics curves(ROC). The sensitivity and specificity were calculated to evaluate NEWSand PEWS values in identifying neonates who were at risk of clinicaldeterioration and required transfer to the neonatal intensive care unit(NICU).Results: Among350patients,170cases required transfer to NICU forclinical deterioration (NICU group), while the other180cases stayed ingeneral ward until discharge (NICU group).The NEWS scores of the NICU group were [3(2to4)] points, which were higher than those of non-NICUgroup [0(0to1)] point (z=-15.278,P<0.05).The NEWS area under thereceiver operating characteristic curve was0.958(95%CI), Scores above2points could predict the need for admission to the NICU with87.6%sensitivity and97.2%specificity. The sensitivity of NEWS was higher thanthose ofPEWS (PEW127.1%and PEW256.5%). NEWS had advantage injudging patients with sepsis or respiratory disorders with sensitivity95.3%.Conclusion: The PEWS tool was found to be a reliable and validscoring system to identify neonates who were at risk of clinicaldeterioration and required transfer to NICU. Especially its simplicity allowssuccessful and safe use by non-pediatric specialists.