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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Ruangsomboon, Onlak Phanprasert, Nutthida Jirathanavichai, Supawich Puchongmart, Chanokporn Boonmee, Phetsinee Thirawattanasoot, Netiporn Dorongthom, Thawonrat praphruetkit, Nattakarn Monsomboon, Apichaya |
| Abstract | Background Many early warning scores (EWSs) have been validated to prognosticate adverse outcomes of COVID-19 in the Emergency Department (ED), including the quick Sequential Organ Failure Assessment (qSOFA), the Modified Early Warning Score (MEWS), and the National Early Warning Score (NEWS). However, the Rapid Emergency Medicine Score (REMS) has not been widely validated for this purpose. We aimed to assess and compare the prognostic utility of REMS with that of qSOFA, MEWS, and NEWS for predicting mortality in emergency COVID-19 patients. Methods We conducted a multi-center retrospective study at five EDs of various levels of care in Thailand. Adult patients visiting the ED who tested positive for COVID-19 prior to ED arrival or within the index hospital visit between January and December 2021 were included. Their EWSs at ED arrival were calculated and analysed. The primary outcome was all-cause in-hospital mortality. The secondary outcome was mechanical ventilation. Results A total of 978 patients were included in the study; 254 (26%) died at hospital discharge, and 155 (15.8%) were intubated. REMS yielded the highest discrimination capacity for in-hospital mortality (the area under the receiver operator characteristics curves (AUROC) 0.771 (95% confidence interval (CI) 0.738, 0.804)), which was significantly higher than qSOFA (AUROC 0.620 (95%CI 0.589, 0.651); p < 0.001), MEWS (AUROC 0.657 (95%CI 0.619, 0.694); p < 0.001), and NEWS (AUROC 0.732 (95%CI 0.697, 0.767); p = 0.037). REMS was also the best EWS in terms of calibration, overall model performance, and balanced diagnostic accuracy indices at its optimal cutoff. REMS also performed better than other EWSs for mechanical ventilation. Conclusion REMS was the early warning score with the highest prognostic utility as it outperformed qSOFA, MEWS, and NEWS in predicting in-hospital mortality in COVID-19 patients in the ED. |
| Related Links | https://bmcemergmed.biomedcentral.com/counter/pdf/10.1186/s12873-023-00814-w.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| DOI | 10.1186/s12873-023-00814-w |
| Journal | BMC Emergency Medicine |
| Issue Number | 1 |
| Volume Number | 23 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-04-26 |
| Access Restriction | Open |
| Subject Keyword | Emergency Medicine Medicine Public Health covid-19 Early warning score Rapid emergency medicine score Medicine/Public Health |
| Content Type | Text |
| Resource Type | Article |
| Subject | Emergency Medicine |
| Journal Impact Factor | 2.3/2023 |
| 5-Year Journal Impact Factor | 2.5/2023 |
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