A validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomy
Abstract Objectives Early warning scores (EWS) aim to rapidly identify patients at risk of critical illness or life-threatening events before deterioration occurs in clinical settings. This study aims to validate the ability of three commonly used early warning scores, namely the National Early Warn...
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BMC
2025-02-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-024-03586-0 |
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| author | Xinli Shi Huijuan Jie Naifa Li Qiongshan Liu Yue Wang Changquan Wu Wenwen Jiang Bolin Zhang Shurong Lai Honglu Xu |
| author_facet | Xinli Shi Huijuan Jie Naifa Li Qiongshan Liu Yue Wang Changquan Wu Wenwen Jiang Bolin Zhang Shurong Lai Honglu Xu |
| author_sort | Xinli Shi |
| collection | DOAJ |
| description | Abstract Objectives Early warning scores (EWS) aim to rapidly identify patients at risk of critical illness or life-threatening events before deterioration occurs in clinical settings. This study aims to validate the ability of three commonly used early warning scores, namely the National Early Warning Score (NEWS), the Early Warning Score (SEWS), and the Modified Early Warning Score (MEWS), to identify patients with deterioration after gastric cancer resection in general wards. Methods This retrospective case-control study included 110 patients who experienced clinical deterioration after gastrectomy for gastric cancer as case group, and 745 patients without deterioration as control group from a tertiary hospital in Guangdong Province, China. The discriminating ability (receiver operating characteristic curves), calibration (goodness-of-fit test) and net benefit (clinical decision curves) of the three EWS (NEWS, SEWS, MEWS) were explored to compare their early warning performance for patients at risk of post-operative deterioration. Results MEWS (goodness-of-fit p = 0.123 > 0.05) and SEWS (goodness-of-fit p = 0.235 > 0.05) both demonstrate good calibration and good discrimination ability (AUC 0.710, 95% CI 0.654–0.766;AUC 0.756, 95% CI 0.701–0.811). In contrast, NEWS not only has good calibration (goodness-of-fit p = 0.283 > 0.05) but also exhibits the best discrimination ability among the three scoring systems (AUC 0.835, 95% CI 0.785–0.884) and the highest net benefit. Conclusion Overall, NEWS may be more suitable for identifying gastric cancer patients at risk of post-operative clinical deterioration, as the early warning scoring model with best performance currently for post-gastrectomy observation. |
| format | Article |
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| institution | DOAJ |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-5ffb9ed13a1041cd84ad13574ca65b762025-08-20T02:59:35ZengBMCBMC Gastroenterology1471-230X2025-02-012511910.1186/s12876-024-03586-0A validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomyXinli Shi0Huijuan Jie1Naifa Li2Qiongshan Liu3Yue Wang4Changquan Wu5Wenwen Jiang6Bolin Zhang7Shurong Lai8Honglu Xu9Department of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Nursing, The Seventh Affiliated Hospital, Sun Yat-sen UniversityAbstract Objectives Early warning scores (EWS) aim to rapidly identify patients at risk of critical illness or life-threatening events before deterioration occurs in clinical settings. This study aims to validate the ability of three commonly used early warning scores, namely the National Early Warning Score (NEWS), the Early Warning Score (SEWS), and the Modified Early Warning Score (MEWS), to identify patients with deterioration after gastric cancer resection in general wards. Methods This retrospective case-control study included 110 patients who experienced clinical deterioration after gastrectomy for gastric cancer as case group, and 745 patients without deterioration as control group from a tertiary hospital in Guangdong Province, China. The discriminating ability (receiver operating characteristic curves), calibration (goodness-of-fit test) and net benefit (clinical decision curves) of the three EWS (NEWS, SEWS, MEWS) were explored to compare their early warning performance for patients at risk of post-operative deterioration. Results MEWS (goodness-of-fit p = 0.123 > 0.05) and SEWS (goodness-of-fit p = 0.235 > 0.05) both demonstrate good calibration and good discrimination ability (AUC 0.710, 95% CI 0.654–0.766;AUC 0.756, 95% CI 0.701–0.811). In contrast, NEWS not only has good calibration (goodness-of-fit p = 0.283 > 0.05) but also exhibits the best discrimination ability among the three scoring systems (AUC 0.835, 95% CI 0.785–0.884) and the highest net benefit. Conclusion Overall, NEWS may be more suitable for identifying gastric cancer patients at risk of post-operative clinical deterioration, as the early warning scoring model with best performance currently for post-gastrectomy observation.https://doi.org/10.1186/s12876-024-03586-0Gastric cancerPostoperativeComplicationsEarly warning scores |
| spellingShingle | Xinli Shi Huijuan Jie Naifa Li Qiongshan Liu Yue Wang Changquan Wu Wenwen Jiang Bolin Zhang Shurong Lai Honglu Xu A validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomy BMC Gastroenterology Gastric cancer Postoperative Complications Early warning scores |
| title | A validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomy |
| title_full | A validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomy |
| title_fullStr | A validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomy |
| title_full_unstemmed | A validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomy |
| title_short | A validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomy |
| title_sort | validation study of three early warning scores in early identification of gastric cancer patients with deteriorating condition after gastrectomy |
| topic | Gastric cancer Postoperative Complications Early warning scores |
| url | https://doi.org/10.1186/s12876-024-03586-0 |
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