Comparative Evaluation of National Early Warning Score (NEWS) and qSOFA Score in Predicting Outcomes Among Patients with Suspected Sepsis: A Cross-Sectional Study
Abstract
Background: Sepsis remains a leading cause of hospitalization-associated mortality worldwide, with delayed recognition being the primary obstacle to preventing progression to septic shock. The National Early Warning Score (NEWS) has emerged as a promising triage tool for sepsis assessment, though its performance across different hospital settings requires further evaluation. Objective: To evaluate the efficacy of NEWS as a screening instrument compared to qSOFA in predicting sepsis-related outcomes among adult patients with suspected sepsis in both ICU and non-ICU settings. Methods: A cross-sectional study was conducted among 65 adult patients with suspected sepsis at a tertiary care hospital in India over 18 months (March 2021-June 2022). NEWS and qSOFA scores were calculated for all participants. The primary endpoints were ICU admission, survival, and mortality. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Results: The mean age was 60.04±14.36 years, with 53.8% males and 46.2% females. Comorbidities included hypertension (50.8%), diabetes mellitus (67.7%), and malignancy (7.7%). Culture positivity was 67.6%, with Klebsiella pneumoniae (26.7%) and E. coli (20%) being the predominant organisms. Non-survivors (41.5%) had significantly higher NEWS and qSOFA scores compared to survivors (P<0.01). NEWS demonstrated AUC of 0.817 (95% CI: 0.702-0.931) with 86% sensitivity and 52% specificity at cut-off 9.5, while qSOFA showed AUC of 0.751 (95% CI: 0.618-0.884) with 82% sensitivity and 55% specificity at cut-off 1.5. Conclusion: NEWS demonstrates superior sensitivity in predicting mortality among patients with suspected sepsis, making it a promising and efficient triage tool for risk stratification. Further research with larger sample sizes is warranted to optimize NEWS specificity and validate these findings across diverse healthcare settings.