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dc.contributor.authorFaisal, Muhammad*
dc.contributor.authorScally, Andy J.*
dc.contributor.authorElgaali, M.A.*
dc.contributor.authorRichardson, D.*
dc.contributor.authorBeatson, K.*
dc.contributor.authorMohammed, Mohammed A.*
dc.date.accessioned2017-12-13T15:22:04Z
dc.date.available2017-12-13T15:22:04Z
dc.date.issued2018-02-01
dc.identifier.citationFaisal M, Scally A, Elgaali MA et al (2018) The National Early Warning Score and its subcomponents recorded within ±24 hours of emergency medical admission are poor predictors of hospital-acquired acute kidney injury. Clinical Medicine. 18(1): 47-53.en_US
dc.identifier.urihttp://hdl.handle.net/10454/14183
dc.descriptionYesen_US
dc.description.abstractBackground: Hospital-acquired Acute Kidney Injury (H-AKI) is a common cause of avoidable morbidity and mortality. Aim: To determine if the patients’ vital signs data as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. Methods: Analyses of emergency admissions to York hospital over 24-months with NEWS data. We report the area under the curve (AUC) for logistic regression models that used the index NEWS (model A0), plus age and sex (A1), plus subcomponents of NEWS (A2) and two-way interactions (A3). Likewise for maximum NEWS (models B0,B1,B2,B3). Results: 4.05% (1361/33608) of emergency admissions had H-AKI. Models using the index NEWS had the lower AUCs (0.59 to 0.68) than models using the maximum NEWS AUCs (0.75 to 0.77). The maximum NEWS model (B3) was more sensitivity than the index NEWS model (A0) (67.60% vs 19.84%) but identified twice as many cases as being at risk of H-AKI (9581 vs 4099) at a NEWS of 5. Conclusions: The index NEWS is a poor predictor of H-AKI. The maximum NEWS is a better predictor but seems unfeasible because it is only knowable in retrospect and is associated with a substantial increase in workload albeit with improved sensitivity.
dc.description.sponsorshipThe Health Foundation
dc.language.isoenen_US
dc.rights© Royal College of Physicians 2018. All rights reserved. Reproduced in accordance with the publisher's self-archiving policy.
dc.subjectHospital-acquired acute kidney injury; National early warning score; Discrimination; Predictive model; Emergency admissionsen_US
dc.titleThe National Early Warning Score and its subcomponents recorded within ±24 hours of emergency medical admission are poor predictors of hospital-acquired acute kidney injuryen_US
dc.status.refereedYesen_US
dc.date.Accepted2017-10-26
dc.date.application2018-02-01
dc.typeArticleen_US
dc.type.versionPublished versionen_US
dc.identifier.doihttps://doi.org/10.7861/clinmedicine.18-1-47


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