NEWS, NEWS2, and qSOFA accuracy in predicting sepsis-related mortality in acute myeloid leukemia: a retrospective single-center analysis.

Porto biomedical journal Pub Date : 2024-10-14 eCollection Date: 2024-09-01 DOI:10.1097/j.pbj.0000000000000266
Ana M Meireles, Leonardo M Moço, Cláudia S Moreira, Gil P Brás, Ana E Santo, Mário Mariz
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Abstract

Acute myeloid leukemia (AML) treated with intensive chemotherapy carries a high risk of severe infection. The development of reliable assessment tools to promptly identify patients at risk of developing critical illness is essential to prevent delays in intensive care unit (ICU) admission. This study evaluated the accuracy of quick Sequential Organ Failure Assessment (qSOFA) score, National Early Warning Score (NEWS), and NEWS2 score in predicting ICU admission and sepsis-related mortality in this population. A retrospective analysis was conducted, including 365 episodes of febrile neutropenia in 126 patients. The results showed that all three scores-qSOFA, NEWS, and NEWS2-demonstrated good accuracy for all outcomes, with area under the receiver-operating characteristic curve values for sepsis-related mortality of 0.812, 0.858, and 0.848, respectively. In addition, the scores exhibited excellent accuracy in predicting ICU admission and the composite outcome of ICU admission or sepsis-related mortality. To our knowledge, this is the first study to evaluate the accuracy of NEWS in a population of patients with AML who did not undergo stem cell transplantation. These findings suggest that NEWS and NEWS2 are effective tools for identifying patients with AML at high risk of clinical deterioration during febrile neutropenia, supporting their use in clinical practice.

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NEWS、NEWS2 和 qSOFA 预测急性髓性白血病败血症相关死亡率的准确性:一项回顾性单中心分析。
接受强化化疗的急性髓性白血病(AML)极易发生严重感染。开发可靠的评估工具来及时识别有危重症风险的患者,对于防止重症监护病房(ICU)入院延误至关重要。本研究评估了快速序贯器官衰竭评估(qSOFA)评分、国家预警评分(NEWS)和NEWS2评分在预测该人群入住重症监护病房和脓毒症相关死亡率方面的准确性。研究人员对 126 名患者的 365 次发热性中性粒细胞减少进行了回顾性分析。结果显示,qSOFA、NEWS 和 NEWS2 这三种评分对所有结果都表现出良好的准确性,脓毒症相关死亡率的接收者工作特征曲线下面积值分别为 0.812、0.858 和 0.848。此外,这些评分在预测入住重症监护室以及入住重症监护室或脓毒症相关死亡率的综合结果方面也表现出了极高的准确性。据我们所知,这是第一项在未接受干细胞移植的急性髓细胞性白血病患者中评估NEWS准确性的研究。这些研究结果表明,NEWS 和 NEWS2 是识别发热性中性粒细胞减少症期间临床恶化风险较高的急性髓细胞白血病患者的有效工具,支持在临床实践中使用。
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