Dr. Veronica Marosi

Garbagnate Milanese Hospital, Italy

Title: National Early Warning Score 2 to identify sepsis in the emergency department. A review of the literature


Aims: The aim of this study is to understand the described sensitivity and specificity in the literature of the score NEWS2 to identify early patients at developmental risk for sepsis through the use of the score in the intra-hospital triage phase, comparing it with the diagnostic accuracy of qSOFA: Quick Sequential [Sepsis-related] Organ Failure Assessment for sepsis with organ dysfunction, infection-related mortality, or ICU due to infection, especially in patients by priority code level 3, 4, and 5 as levels 1 and 2 represent absence or rapid deterioration of one or more vital functions and risk of impairment of vital functions, respectively.

Materials and Methods: The study is based on a literature review by querying four databases, including PubMed, Cinahl, Embase, and Cochrane Library and the Guidelines of the Regional Health Council of Tuscany Region (2016). The study also asks a question: Does the use of the NEWS 2 early warning system in intrahospital triage lead to early recognition and treatment of patients at high risk for sepsis?

Results: The NEWS is more accurate in predicting mortality or ICU admission due to infection within 72 hours than qSOFA and SIRS in patients suspected of sepsis at initial presentation to the emergency department. This will potentially aid in the early diagnosis of all patients at risk for ED deterioration, including those at risk for sepsis-related mortality.

Conclusions: The use of NEWS 2 is important because of the predictive power of urgent priority, increasing the ability to discriminate patients who may be worsening their condition, despite a priori being otherwise classified. Implementation of the NEWS 2 among hospital-wide triage procedures effectively predicts early mortality and detects high-risk patients.

Keywords: Early Warning Score, Vital signs, qSOFA, NEWS2, sepsis, SIRS.


Veronica Marosi graduated in 2020 at the age of 25 from University of Milan, Italy. She is an Emergency Room Nurse at Garbagnate Milanese Hospital, near Milan, in Italy. In 2021, she published her first article in collaboration with the scientific journal called “Italian Journal of Nursing”.