DISCLAMER: This function calculates the original National Early Warning Score (NEWS) [1], not NEWS-2 [2]. The scoring rules differ slightly from NEWS-2, specifically in oxygen saturation thresholds and mental status classification.
Usage
The NEWS can be calculated using the news_total()
function. This function requires vital parameters as input, which are
then scored according to the NEWS criteria. By default
return_df is FALSE and can be left out, if set
to TRUE the function will return all the inidivual elements
of the NEWS score instead of only the totals. Assuming your vital
parameters are stored in dataframe df with columns
hr, rf, temp, sbp,
avpu, gcs, o2supp, and
spo2, you can calculate the NEWS score as follows:
result <- news_total <- function(df$hr, df$rf, df$temp, df$sbp, df$avpu, df$gcs, df$o2supp, df$spo2)By default, the function only returns the total NEWS score, but you
can also return the individual components of the NEWS score by setting
return_df = TRUE. This will return a dataframe with all the
individual components of the NEWS score.
result <- news_total <- function(df$hr, df$rf, df$temp, df$sbp, df$avpu, df$gcs, df$o2supp, df$spo2, return_df = TRUE)If all eight components scores are missing, the returned total NEWS
score will be NA.
Calculations
Heart rate (HR)
| Points | Criteria (bpm) |
|---|---|
| 0 | 51–90 |
| 1 | 41–50 OR 91–110 |
| 2 | 111–130 |
| 3 | ≤ 40 OR ≥ 131 |
If HR is missing, NA is returned.
Respiratory rate (RR)
| Points | Criteria (breaths/min) |
|---|---|
| 0 | 12–20 |
| 1 | 9–11 |
| 2 | 21–24 |
| 3 | ≤ 8 OR ≥ 25 |
If RR is missing, NA is returned.
Temperature (Temp)
| Points | Criteria (°C) |
|---|---|
| 0 | 36.1–38.0 |
| 1 | 35.1–36.0 OR 38.1–39.0 |
| 2 | ≥ 39.1 |
| 3 | ≤ 35.0 |
If Temp is missing, NA is returned.
Systolic blood pressure (SBP)
| Points | Criteria (mmHg) |
|---|---|
| 0 | 111–219 |
| 1 | 101–110 |
| 2 | 91–100 |
| 3 | ≤ 90 OR ≥ 220 |
If SBP is missing, NA is returned.
Level of consciousness (AVPU/GCS)
Variables used:
- AVPU (Alert, Voice, Pain, Unresponsive, or “D” for “Drowsy”).
- GCS (Glasgow Coma Scale).
NOTE: AVPU is assessed first. Only if AVPU is missing is GCS used as a substitute.
| Points | Criteria |
|---|---|
| 0 | AVPU = Alert (A) OR GCS = 15 |
| 3 | AVPU = V, P, U, D OR (AVPU missing AND GCS ≤ 14) |
If both AVPU and GCS are missing, NA is returned.