ToolsCalculators
Newsom Score for Non-traumatic Chest Pain
Identifies emergency department chest-pain patients in whom a screening chest x-ray can reasonably be deferred.
Newsom Score for Non-traumatic Chest Pain
Age >= 60 years
History of congestive heart failure
Smoking history
Hemoptysis
History of tuberculosis
History of thromboembolic disease
Current or prior alcohol abuse
Fever >= 38.0 C (100.4 F)
Oxygen saturation < 90%
Respiratory rate > 24/min
Diminished breath sounds on exam
Rales on exam
ResultLow risk
No criterion is present; a clinically significant chest x-ray finding is unlikely, and imaging may reasonably be deferred.
- Criteria present
- 0 of 12
When to use
- Deciding whether an adult with atraumatic, non-cardiac-appearing chest pain and low pretest probability of acute coronary syndrome needs a screening chest x-ray.
- Reducing low-yield chest imaging in the emergency department.
Formula
Presence of any one of 12 findings (age >=60y, CHF history, smoking history, hemoptysis, TB history, thromboembolic history, alcohol abuse, fever >=38C, SpO2 <90%, RR >24, diminished breath sounds, rales) classifies the patient as not low-risk; absence of all 12 identifies a group in whom a clinically significant radiographic finding is unlikely.
Pearls and pitfalls
- Designed to detect pneumonia, effusion, pneumothorax, heart failure, or mass, not to evaluate for acute coronary syndrome.
- The rule missed occasional pneumonias and effusions on validation, so persistent clinical suspicion should override a low-risk result.