Hubungan National Early Warning Score 2 terhadap Mortalitas Jangka Pendek pada Pasien Neurokritikal di Rumah Sakit Adam Malik Medan

Abstract

Background: Neurocritical patients are at high risk of early clinical deterioration and short-term mortality due to acute neurological injury accompanied by systemic physiological disturbances. Early assessment of disease severity is essential for identifying patients at increased risk of mortality. The National Early Warning Score 2 (NEWS2) is a physiological scoring system designed to detect clinical deterioration; however, its association with short-term mortality in neurocritical patients requires further evaluation. Objective: To determine the association between National Early Warning Score 2 (NEWS2) and short-term mortality in neurocritical patients admitted to the intensive care unit of Adam Malik General Hospital, Medan. Method: This was a prospective cohort study involving 62 neurocritical patients admitted to the ICU. NEWS2 was calculated using physiological parameters recorded within the first 24 hours of intensive care unit admission. The outcome was 14- day mortality. Bivariate analysis was performed to assess the association between NEWS2 and mortality. Receiver operating characteristic (ROC) analysis was used as an additional method to evaluate the strength of the association and to identify the optimal cutoff value. Result: The 14-day mortality rate was 64.5%, with a median NEWS2 score of 7 (range 2–14). A NEWS2 score >6 was significantly associated with increased 14- day mortality (RR 1.710; 95% CI: 1.109–2.638; p = 0.007). ROC analysis yielded an area under the curve (AUC) of 0.768, with a sensitivity of 67.5% and specificity of 68.2% at the cutoff >6. Conclusion: A significant association between NEWS2 score and short-term mortality was observed in neurocritical patients. Higher NEWS2 scores were associated with an increased risk of short-term mortality, supporting the role of NEWS2 as a clinical risk stratification tool in the ICU.