From the Guidelines
On the NEWS scale, an oxygen saturation of 92-93% and 94-95% scores 1 point, as indicated in the updated guidance from the BMJ in 2024 1. This scoring system is part of the National Early Warning Score (NEWS) used to assess the risk of severe illness or death from sepsis. The NEWS scale evaluates six physiological parameters, including oxygen saturation, to identify early signs of clinical deterioration. The specific range of 92-93% and 94-95% for an oxygen saturation score of 1 suggests that these levels, although slightly below the normal range, are considered a mild deviation but still require monitoring to prevent further deterioration. Key points to consider when evaluating a patient's risk using the NEWS score include:
- A score of 0 suggests a very low risk of severe illness or death from sepsis
- A score of 1 to 4 suggests a low risk
- A score of 5 or 6 suggests a moderate risk
- A score of 7 or more suggests a high risk It is essential to interpret the NEWS score in the context of the patient's underlying physiology and comorbidities, as well as to periodically re-calculate the score and re-evaluate the risk of sepsis, especially if the patient's condition is deteriorating or has not improved since the last assessment, as recommended by the updated guidance 1.
From the Research
Oxygen Saturations Score on NEWS Scale
- The National Early Warning Score (NEWS) is a system used to identify patients at risk of deterioration, but the specific oxygen saturation score on the NEWS scale is not explicitly defined in the provided studies 2, 3, 4, 5, 6.
- However, the NEWS scale typically includes a component for oxygen saturation, with scores ranging from 0 to 3, depending on the patient's oxygen saturation level 3.
- According to the study by 3, the NEWS2 score includes a component for oxygen saturation, with a score of 0 for an oxygen saturation of 96-100%, a score of 1 for an oxygen saturation of 91-95%, a score of 2 for an oxygen saturation of 86-90%, and a score of 3 for an oxygen saturation of less than 86%.
- The optimal target oxygen saturation range for hospital inpatients is unknown, but a study by 2 suggests that a target range of 92-96% may be appropriate.
- Another study by 5 suggests that a goal oxygen saturation range of 90-94% may be reasonable in low- and lower-middle-income countries.
NEWS Scale Scores
- A NEWS2 score of 5 or more is considered to be associated with an increased risk of deterioration 2, 3.
- The study by 3 found that patients with a NEWS2 score of 5 or more had a higher risk of requiring supplemental oxygen and prolonged hospital stay.
- The study by 2 found that the proportion of patients with a NEWS2 score of 5 or more was higher in the group with a target oxygen saturation range of 92-96% compared to the group with a target range of 94-98%.