The use of early warning score in cardiology: integrative review
DOI:
https://doi.org/10.33448/rsd-v12i4.40945Keywords:
Clinical deterioration; Cardiac Arrest; Peditric; Patient safety; Early Warning Escore; Early warning escore.Abstract
Introduction: Physiological deterioration usually precedes serious patient events, such as death, cardiac arrest and admission to the intensive care unit. The additive early warning scores of physiological variables are an attempt to predict and prevent these events. Objective: To search for evidence in the literature on the applicability of the Alert NEWS and PEWS scores in cardiology for the preparation of practical recommendations. Method: Integrative literature review that included original articles from the MEDLINE, LILACS and BDENF databases, in the time frame from 2017 to 2022. The synthesis of the articles was done descriptively according to the type of approach. Results: 1147 articles were identified, of which seven were included in this review, published in English, Portuguese and Spanish. All articles sought to assess the applicability and confidence level of alert scores. Conclusion: The current alert system tools perform well in predicting death and cardiac arrest within a time frame of 24-48 hours, with a significant impact on hospital health outcomes and the reduction of cardiorespiratory cardiac arrest cases, Intensive Care Unit admission. Finally, early warning scores prove to be a reliable tool for detecting clinical conditions, the adoption of complementary factors such as biomarkers are an excellent complementary strategy in the detection of early deterioration in patients with acute heart failure.
References
Akel, M. A., Carey, K. A., Winslow, C. J., Churpek, M. M., & Edelson, D. P. (2021). Less is more: Detecting clinical deterioration in the hospital with machine learning using only age, heart rate, and respiratory rate. Resuscitation. 168, 6-10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128300/pdf/nihms-1804588.pdf
Aly, D. M., Erickson, L. A., Hancock, H., Apperson, J. W., Gaddis, M., Shirali, G., & Goudar, S. (2021). Ability of video telemetry to predict unplanned hospital admissions for single ventricle infants. Journal of the American Heart Association. 10(16), e020851. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475020/pdf/JAH3-10-e020851.pdf
Berge, K., Brynildsen, J., Røysland, R., Strand, H., Christensen, G., Høiseth, A. D., & Lyngbakken, M. N. (2022). Prognostic value of cardiac biomarkers and National Early Warning Score 2 in acute dyspnoea. Open Heart. 9(1), e001938. https://openheart.bmj.com/content/9/1/e001938.long
Branco, M. J. C., Lucas, A. P. M., Marques, R. M. D., & Sousa, P. P. (2020). The role of the nurse in caring for the critical patient with sepsis. Revista brasileira de enfermagem. 73. https://doi.org/10.1590/0034-7167-2019-0031
Centro Oxford de Medicina Baseada em Evidências. (2022). https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009
Chiu, Y. D., Villar, S. S., Brand, J. W., Patteril, M. V., Morrice, D. J., Clayton, J., & Mackay, J. H. (2020). Logistic early warning scores to predict death, cardiac arrest or unplanned intensive care unit re‐admission after cardiac surgery. Anaesthesia. 75(2), 162-170. https://doi.org/10.1111/anae.14755
Hogan, H., Hutchings, A., Wulff, J., Carver, C., Holdsworth, E., Welch, J., & Black, N. (2019). Interventions to reduce mortality from in-hospital cardiac arrest: a mixed-methods study. Health Services and Delivery Research, 7(2), 1-110. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK536335/
Jones, M. (2012). NEWSDIG: The national early warning score development and implementation group. Clinical medicine. 12(6), 501. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922584/
Knobloch, K., Yoon, U., & Vogt, P. M. (2011). Preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and publication bias. Journal of Cranio-Maxillofacial Surgery. 39(2), 91-92. https://pubmed.ncbi.nlm.nih.gov/21145753/
Li, H., Wu, T. T., Yang, D. L., Guo, Y. S., Liu, P. C., Chen, Y., & Xiao, L. P. (2019). Decision tree model for predicting in‐hospital cardiac arrest among patients admitted with acute coronary syndrome. Clinical Cardiology. 42(11), 1087-1093. https://pubmed.ncbi.nlm.nih.gov/31509271/
Mendes, K. D. S., Silveira, R. C. D. C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto-enfermagem. 17, 758-764. https://doi.org/10.1590/S0104-07072008000400018
Miranda, J. D. O. F., Camargo, C. L. D., Nascimento Sobrinho, C. L., Portela, D. S., Monaghan, A., Freitas, K. S., & Mendoza, R. F. (2016). Tradução e adaptação de um escore pediátrico de alerta precoce. Revista Brasileira de Enfermagem. 69,888-896. https://www.scielo.br/j/reben/a/4KbfDNVHgdx5n3k3TNr9jJx/?format=pdf&lang=pt
Miranda, J. D. O. F., Camargo, C. L. D., Nascimento Sobrinho, C. L., Portela, D. S., Pinho, P. D. S., & Oliveira, T. D. L. (2020). Factors associated with the clinical deterioration recognized by an early warning pediatric score. Texto & Contexto-Enfermagem. 29. https://doi.org/10.1590/1980-265X-TCE-2018-0348
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Itens de relatório preferidos para revisões sistemáticas e meta-análises: a declaração PRISMA. PLoS Med. 6(7), e1000097. http://www.prisma-statement.org/?AspxAutoDetectCookieSupport=1
Monaghan, A. (2005). Detecting and managing deterioration in children. Paediatric nursing, 17(1), 32. https://www.proquest.com/openview/5c32fbcb6b2fb6725dc4240a119ccb51/1?pq-origsite=gscholar&cbl=33983
Oliveira, A. P. A. D., Urbanetto, J. D. S., & Caregnato, R. C. A. (2020a). National Early Warning Score 2: adaptação transcultural para o português do Brasil. Revista Gaúcha de Enfermagem. 41. https://doi.org/10.1590/1983-1447.2020.20190424
Oliveira, G. N., Reis, T. C., Cruz, D. D. A. L. M. D., & Nogueira, L. D. S. (2020b). Alteração de sinais vitais e desfecho clínico de pacientes admitidos em unidade de emergência. Rev. enferm. UFSM. e81-e81. https://doi.org/10.5902/2179769242559
Page, M. J., & Moher, D. (2017). Evaluations of the uptake and impact of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement and extensions: a scoping review. Systematic reviews. 6(1), 1-14. https://doi.org/10.1186/s13643-017-0663-8
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., & Moher, D. (2022). A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas. Rev Panam Salud Publica. 46, dic. 46:e112. https://doi.org/10.26633/RPSP.2022.112
Rossetti, S. C., Dykes, P. C., Knaplund, C., Kang, M. J., Schnock, K., Garcia Jr, J. P., & Cato, K. (2021). The Communicating Narrative Concerns Entered by Registered Nurses (CONCERN) Clinical Decision Support Early Warning System: Protocol for a Cluster Randomized Pragmatic Clinical Trial. JMIR Research Protocols. 10(12), e30238. https://doi.org/10.2196/30238
Santos, C. M. D. C., Pimenta, C. A. D. M., & Nobre, M. R. C. (2007). A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Revista latino-americana de enfermagem. 15, 508-511. https://doi.org/10.1590/S0104-11692007000300023
Silva, S. R. R. D. (2022). Utilização da Ferramenta de Avaliação do Nível de Deterioração Precoce (NEWS) em pacientes com covid-19 e a intervenção da equipe fisioterapêutica em um hospital campanha da Paraíba (Master's thesis, Universidade Federal do Rio Grande do Norte). https://repositorio.ufrn.br/bitstream/123456789/50854/1/UtilizacaoFerramentaAvaliacao_Silva_2022.pdf
Spångfors, M., Molt, M., & Samuelson, K. (2020). In-hospital cardiac arrest and preceding National Early Warning Score (NEWS): A retrospective case-control study. Clinical Medicine. 20(1), 55. https://doi.org/10.7861/clinmed.2019-0137
Villanueva-Rábano, R., Martín-Rodríguez, F., & López-Izquierdo, R. (2021). National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care. Investigación y Educación en Enf. 39(3):e05. https://doi.org/10.17533/udea.iee.v39n3e05
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Leandro Kasama Shibata; Selma Rossi Gentil; Sérgio Henrique Simonetti
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.