Age-Associated Changes in Value of the National Early Warning Score with the Japanese-Modified Glasgow Prognostic Score (NEWS-JmGPS) for Predicting In-Hospital Mortality of Elderly Patients Visiting the Emergency Department
Author(s): Toshiya Mitsunaga, Izumu Hasegawa, Masahiko Uzura, Kenji Okuno, Akihiro Sekine, Satoshi Takeda
Objective: The aim of this study is to evaluate the usefulness of the National Early Warning Score with the Japanese-modified Glasgow Prognostic Score (NEWS-JmGPS) for predicting in-hospital mortality of elderly patients. We also clarify the value of the NEWS-JmGPS for predicting in-hospital mortality of patients older than 75, 80, and 85 years.
Methods: This is secondary analysis of a retrospective, single-centred observational study conducted in one year, at the Emergency Department (ED) of Jikei University Kashiwa Hospital. A total of 1,830 acute medical patients age 65 and older were included in this study. Discrimination was assessed by plotting the receiver operating characteristics (ROC) curve and calculating the area under the ROC curve (AUC).
Results: The AUC of the NEWS-JmGPS was significantly higher than that of the NEWS for predicting in-hospital mortality (0.817 for the NEWSJmGPS, 0.797 for the NEWS) (p < 0.001). In the groups of older than 75 and 80 years, the AUC of NEWSJmGPS and NEWS for predicting in-hospital mortality were higher than those of the groups of younger than 75 and 80 years. On the other hand, in the group of older than 85 years, the AUC of NEWS-JmGPS and NEWS for predicting in-hospital mortality were lower than those of the group of younger than 85 years.
Conclusion: Our study demonstrated the utility of the NEWS-JmGPS as a strong predictor of in-hospital mortality in elderly patients. However, in the oldest-old patients older than 85 years, the NEWS-JmGPS does not have strong power for predicting in-hospital mortality.