The Performance of Risk Scoring Systems Used for Severe COVID-19 Cases in The Emergency Department

Abstract

Objective: The aim of this study is to evaluate the performance of CURB-65, Quick Sequential Organ Failure Assessment (qSOFA), and National Early Warning Score 2 (NEWS 2) scores in predicting mortality in COVID-19 patients in emergency department. Method: A total of 502 patients diagnosed with severe COVID-19 in the emergency department of a pandemic hospital were analyzed retrospectively. Demographic, clinical and laboratory data of the patients were obtained from the hospital registry system. The CURB-65, qSOFA, and NEWS2 scores of each patient were calculated separately. These patients were divided into two groups as those who survived and those who died. All parameters and calculated risk scores were statistically compared between these two groups. Results: While 281 out of 502 patients survived, 221 died. When the CURB-65, NEWS2, qSOFA scores were compared between the two patient groups, a significant difference was found (p<0.001 for all ). Compared with CURB-65 and qSOFA, sensitivity of 92.3% and NPV of 90.2% were detected when NEWS2≥8. The NEWS2 score reached the highest mortality predictive power among other scores with an AUC value of 0.86. Conclusion: Because the NEWS2 score is superior to CURB-65 and qSOFA for predicting mortality, it can be used in the triage of severe COVID-19 patients, predicting prognosis and improving outcomes.

Keywords

• Covıd-19;
• Curb-65;
• News2;
• qsofa;
• emergency service

Acil Serviste Ciddi COVID-19 Vakalarında Kullanılan Risk Puanlama Sistemlerinin Performansı

Abstract

Amaç: Acil serviste COVID-19 hastalarında mortaliteyi öngörmede CURB-65, Quick Sequential Organ Failure Assessment (qSOFA) ve Ulusal Erken Uyarı Skoru 2 (NEWS 2) puanlarının performansını değerlendirmektir. Yöntem: Bir pandemi hastanesinin acil servisinde ciddi COVID-19 tanısı alan toplam 502 hasta geriye dönük olarak incelendi. Hastaların demografik, klinik ve laboratuvar verilerine hastane kayıt sisteminden ulaşıldı. Her hastanın CURB-65, qSOFA ve NEWS2 skorları ayrı ayrı hesaplandı. Bütün hastalar hayatta kalanlar ve ölenler olarak iki gruba ayrıldı. Tüm parametreler ve hesaplanan risk skorları bu iki grup arasında istatistiksel olarak karşılaştırıldı. Bulgular: 502 hastanın 281'i hayatta kalırken, 221'i öldü. CURB-65, NEWS2, qSOFA skorları iki hasta grubu arasında karşılaştırıldığında, anlamlı fark bulundu (p<0,001). CURB-65 ve qSOFA ile karşılaştırıldığında, NEWS2 ≥8 iken, %92,3 hassasiyet ve %90.2 NPV değerlerine sahipti. NEWS2 skoru, 0.86 AUC değeri ile diğer skorlar arasında en yüksek mortalite tahmin gücüne ulaştı. Sonuç: NEWS2 skoru mortaliteyi tahmin etmede CURB-65 ve qSOFA'dan daha üstün bulunduğundan, ciddi COVID-19 hastalarının triyajında, prognozu tahmin etmede ve sonuçları iyileştirmede kullanılabilir.

Keywords

• Covid-19;
• Curb-65;
• News2;
• qsofa;
• acil servis

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