Acil Serviste COVID-19 Hastalarının Prognozunu Tahmin Etmek İçin Erken Uyarı Puanlama Sistemlerinin Kullanımı

Abstract

Aim: Increased emergency department (ED) admissions and the need for intensive care unit (ICU) brought with the pandemic has led to the need to make fast and accurate decisions. Early warning scores (EWS) may be useful in ED in this regard. This study was performed to evaluate the effectiveness of EWS in predicting mortality and need for ICU of patients with COVID-19. Materials and methods: This retrospective observational study was performed with subjects presented to the ED and were later admitted to a general ward or to the ICU because of COVID-19. Subjects aged ≥18 years with positive RT-PCR were included in the study. Subjects experienced a cardiac or respiratory arrest or intubated at the time of presentation to the ED and pregnant women were excluded from the study. MEWS, NEWS, NEWS-2, REMS, and qSOFA scores were calculated using patients’ data on first presentation. We examined the association of these scoring systems with mortality and need for ICU. Results: While 60(10%) of the 600 patients participating in the study were admitted to the ICU, 222(37%) patients died. The scoring systems’ negative predictive values for predicting ICU admission were 0.95, 0.98, 0.97, 0.96, and 0.96 respectively and for predicting mortality were 0.61, 0.67, 0.67, 0.66, and 0.61 respectively. All scorings assessed were significant predictors of the need for ICU and mortality in patients with COVID-19. Conclusions: All evaluated scoring systems were successful; however, NEWS and NEWS-2 had the highest predictive value both for the need for ICU and mortality.