1. A prospective, observational study of the performance of MEWS, NEWS, SIRS and qSOFA for early risk stratification for adverse outcomes in patients with suspected infections at the emergency department
- Author
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V Brown, T. Minderhoud, P. Mohammadi, Pwb Nanayakkara, T Attaye, K. Azijli, R Dekker, S J Huisman, A A Hettinga-Roest, Surgery, Internal medicine, ACS - Diabetes & metabolism, APH - Quality of Care, and APH - Digital Health
- Subjects
medicine.medical_specialty ,business.industry ,Retrospective cohort study ,General Medicine ,Emergency department ,Critical Care and Intensive Care Medicine ,Confidence interval ,Mews ,Organ Dysfunction Scores ,Emergency medicine ,Emergency Medicine ,Internal Medicine ,Medicine ,Observational study ,business ,Risk assessment ,Prospective cohort study - Abstract
Background: Many patients with suspected infection are presented to the emergency Department. Several scoring systems have been proposed to identify patients at high risk of adverse outcomes. Methods: We compared generic early warning scores (MEWS and NEWS) to the (SIRS) criteria and quick Sequential Organ Failure Assessement (qSOFA), for early risk stratification in 1400 patients with suspected infection in the ED. The primary study end point was 30-day mortality. Results: The AUROC of the NEWS score for predicting 30-day mortality was 0.740 (95% Confidence Interval 0.682-0.798), higher than qSOFA (AUROC of 0.689, 95% CI 0.615- 0.763), MEWS (AUROC 0.643 (95% CI 0.583-0.702) and SIRS (AUROC 0.586, 95%CI 0.521 – 0.651). The sensitivity was also highest for NEWS≥ 5 (sensitivity 75,8% specificity of 67,4%). Conclusion: Among patients presenting to the ED with suspected infection, early risk stratification with NEWS (cut-off of ≥5) is more sensitive for prediction of mortality than qSOFA, MEWS or SIRS, with adequate specificity.
- Published
- 2021