Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients

Autor: Marcos Las Heras, Eduardo San Román, Indalecio Carboni Bisso, Nicolás Gemelli, Jorge Sinner, Marcelo Risk, Iván Huespe, Eduardo Prado
Rok vydání: 2023
Předmět:
Zdroj: Medicina Intensiva. 47:9-15
ISSN: 0210-5691
DOI: 10.1016/j.medin.2021.11.002
Popis: Objective: investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24 hours. Design: retrospective multicenter study Setting: two third-level hospitals in Argentina Patients: all adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders. Interventions: Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization. Variables: we evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48 h, and at hospital admission. Results: we evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68-0.78) 24 hours before ICU admission, and 0.52 (95%CI 0.47-0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68-0.78) and 0.52 (95%CI 0.47-0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77-0.84) and 0.61 (95%CI 0.58-0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C. Conclusion: COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization.
Databáze: OpenAIRE