<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-5307</journal-id>
<journal-title><![CDATA[Investigación y Educación en Enfermería]]></journal-title>
<abbrev-journal-title><![CDATA[Invest. educ. enferm]]></abbrev-journal-title>
<issn>0120-5307</issn>
<publisher>
<publisher-name><![CDATA[Imprenta Universidad de Antioquia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-53072021000300005</article-id>
<article-id pub-id-type="doi">10.17533/udea.iee.v39n3e05</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[National Early Warning Score 2 Lactate (NEWS2-L) in Predicting Early Clinical Deterioration in Patients with Dyspnoea in Prehospital Care]]></article-title>
<article-title xml:lang="es"><![CDATA[National Early Warning Score 2 y ácido láctico (NEWS2-L) en la predicción del deterioro clínico precoz en pacientes con disnea en los cuidados prehospitalarios]]></article-title>
<article-title xml:lang="pt"><![CDATA[National Early Warning Score 2 e ácido láctico (NEWS2-L) na predição de deterioração clínica precoce em pacientes com dispneia no atendimento pré-hospitalar]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villanueva-Rábano]]></surname>
<given-names><![CDATA[Raúl]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martín-Rodríguez]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Izquierdo]]></surname>
<given-names><![CDATA[Raúl]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University Clinical Hospital of Valladolid  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Valladolid I Emergency Mobile Unit  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Rio Hortega University Hospital of Valladolid  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Castilla y León Regional Health Management (SACYL)  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,University of Valladolid Department of Medicine, Dermatology and Toxicology ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>39</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-53072021000300005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-53072021000300005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-53072021000300005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective: To evaluate the ability of the NEWS2-L (National Early Warning Score 2 Lactate) scale to predict the risk of early clinical deterioration (mortality within 48 hours) in patients with dyspnoea treated by the Medical Emergency Services compared with NEWS2 and lactate in isolation.  Methods: Prospective, multi-centre study of a cohort of 638 patients with dyspnoea treated in the ambulance and priority-transferred to a hospital emergency service in the cities of Valladolid, Salamanca, Segovia or Burgos (Spain). We collected clinical, analytical and demographic data. The main outcome measure was all-cause mortality within 48 hours. The recommendations of the Royal College of Physicians were followed to calculate NEWS2. When NEWS2 and LA prehospital values were obtained, the two values were added together to obtain the NEWS2-L.  Results: Mortality within 48 hours was fifty-six patients (8.8%). The NEWS2-L scale obtained an area under the curve (AUC) of the receiver operating characteristics (ROC) for mortality within 48 hours of 0.854 (CI 95% 0.790-0.917), at seven days of 0.788 (CI 95% 0.729-0.848) and at 30 days of 0.744 (CI 95% 0.692-0.796); in all cases p&lt;0.001, with a significant decrease between the value at 48 hours and at 30 days.  Conclusion: The NEWS2-L scale was found to be significantly superior to the NEWS2 scale and similar to lactate in predicting early clinical deterioration in patients with dyspnoea. This scale can help a nurse detect these patients early, as part of their regular practice, and thus guide therapeutic efforts.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo: Evaluar la capacidad de la escala NEWS2-L (National Early Warning Score 2-lactate) para predecir el riesgo de deterioro clínico precoz (mortalidad hasta las 48h) en pacientes con disnea atendidos por Servicios de Emergencias Médicas, comparado con la escala NEWS2 y el ácido láctico en solitario.  Métodos: Estudio prospectivo multicéntrico de cohorte de 638 pacientes con disnea atendidos en ambulancia y trasladados con alta prioridad a un servicio de urgencias hospitalarias en las ciudades de Valladolid, Salamanca, Segovia y Burgos (España). Se tomó información de variables clínicas, analíticas y demográficas, de las cuales la de resultado principal fue la mortalidad por cualquier causa hasta las 48 horas. Para el cálculo del NEWS2 se siguieron las recomendaciones del Royal College of Physicians. Una vez obtenidos los valores del NEWS2 y del AL prehospitalario se sumaron ambos valores y se obtuvo la NEWS2-L.  Resultados: La mortalidad, antes de las 48, horas fue de 56 pacientes (8.8%). La escala NEWS2-L obtuvo un Área Bajo la Curva - Característica Operativa del Receptor (ABC-COR) para la mortalidad antes de las 48 horas de 0.854 (IC95% 0.790-0.917), a siete días de 0.788 (IC95% 0.729-0.848) y a 30 días de 0.744 (IC95% 0.692-0.796); en todos los casos p&lt;0.001), lo que experimentó un descenso importante entre su valor a las 48 h y a los 30 días.  Conclusión: La escala NEWS2-L mostró ser significativamente superior a la escala NEWS2 y similar al ácido láctico en la predicción del deterioro clínico precoz en pacientes con disnea. Esta escala es una ayuda para que la enfermera en su práctica habitual detecte a estos pacientes en forma temprana y así poder orientar los esfuerzos terapéuticos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Objetivo: Avaliar a capacidade da escala NEWS2-L (National Early Warning Score 2-lactato) de predizer o risco de deterioração clínica precoce (mortalidade de até 48h) em pacientes com dispneia tratados em Serviços de Emergência Médica, em comparação com a escala NEWS2 e a ácido láctico em solitário.  Métodos: Estudo prospectivo de coorte multicêntrico de 638 pacientes com dispneia atendidos por ambulância e transferidos com alta prioridade para um serviço de emergência hospitalar nas cidades de Valladolid, Salamanca, Segovia e Burgos (Espanha). As informações foram obtidas a partir de variáveis &#8203;&#8203;clínicas, analíticas e demográficas, sendo a principal variável de desfecho a mortalidade por todas as causas em até 48 horas. Para o cálculo do NEWS2, foram seguidas as recomendações do Royal College of Physicians. Uma vez obtidos os valores do NEWS2 e do AL pré-hospitalar, ambos os valores foram somados e o NEWS2-L foi obtido.  Resultados: A mortalidade antes de 48 horas foi de 56 pacientes (8,8%). A escala NEWS2-L obteve uma área sob a curva - característica operacional do receptor (ABC-COR) para mortalidade antes de 48 horas de 0.854 (IC 95% 0.790-0.917), em sete dias de 0.788 (IC 95% 0.729-0.848) e aos 30 dias de 0.744 (95% CI 0.692-0.796); em todos os casos p &lt;0,001), experimentando uma diminuição significativa entre o seu valor às 48 he aos 30 dias.  Conclusão: A escala NEWS2-L mostrou ser significativamente superior à escala NEWS2 e semelhante ao ácido láctico na predição da deterioração clínica precoce em pacientes com dispneia. Essa escala é um auxílio para o enfermeiro em sua prática habitual detectar precocemente esses pacientes e, assim, ser capaz de orientar os esforços terapêuticos.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[dypsnea]]></kwd>
<kwd lng="en"><![CDATA[biomarkers]]></kwd>
<kwd lng="en"><![CDATA[prehospital care]]></kwd>
<kwd lng="en"><![CDATA[early warning score]]></kwd>
<kwd lng="en"><![CDATA[hospital mortality]]></kwd>
<kwd lng="en"><![CDATA[clinical decision-making.]]></kwd>
<kwd lng="es"><![CDATA[disnea]]></kwd>
<kwd lng="es"><![CDATA[biomarcadores]]></kwd>
<kwd lng="es"><![CDATA[atención prehospitalaria]]></kwd>
<kwd lng="es"><![CDATA[puntuación de alerta temprana]]></kwd>
<kwd lng="es"><![CDATA[mortalidad hospitalaria]]></kwd>
<kwd lng="es"><![CDATA[toma de decisiones clínicas]]></kwd>
<kwd lng="pt"><![CDATA[dispneia]]></kwd>
<kwd lng="pt"><![CDATA[biomarcadores]]></kwd>
<kwd lng="pt"><![CDATA[assistência pré-hospitalar]]></kwd>
<kwd lng="pt"><![CDATA[escore de alerta precoce]]></kwd>
<kwd lng="pt"><![CDATA[mortalidade hospitalar]]></kwd>
<kwd lng="pt"><![CDATA[tomada de decisão clínica.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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