Use of NEWS2 to predict length of stay and in hospital mortality at exacerbation of COPD

Background: NEWS2 is a risk score based on routinely collected physiologic measures. We assessed if NEWS2 can be used to predict short-term outcomes for acute exacerbation of COPD (AECOPD) admissions. Methods: Data were collected from 167 English Hospitals participating in the National Asthma and COPD Audit Programme (NACAP) for AECOPD admissions discharged between 01/10/2018 and 30/09/2019. NEWS2 was recorded on arrival to hospital. A mixed-effects logistic regression examined the association between NEWS2 risk category (low, medium, high) and AECOPD outcomes (inpatient mortality, received NIV, length of stay > median [4 days]) using a random effect for hospital. Regression models were adjusted for age, sex, deprivation, GOLD stage, smoking status, history of cardiovascular disease, and history of mental illness. Results: Of the 78302 patients included in the study 4% died during admission, 10% required NIV, and 41% had a length of stay longer than the median. There was a significant increase in odds of death, requirement for NIV, and longer length of stay for each increase in risk category (table). Conclusion: Admission NEWS2 classified as high, medium, and low risk appears to predict short-term outcomes for AECOPD admissions.