1. National early warning score to predict intensive care unit transfer and mortality in COVID‐19 in a French cohort
- Author
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Jacques Desbordes, Arnaud Scherpereel, Elodie Drumez, Lille Covid-team, Cécile Yelnik, Amélie Bruandet, Delphine Garrigue, Ady Assaf, Marc Lambert, Emmanuel Faure, Anne Goffard, Karine Faure, Mohammad Ryadh Pokeerbux, Julien Labreuche, Charles Garabedian, and Julien Poissy
- Subjects
Adult ,Male ,medicine.medical_specialty ,education ,030204 cardiovascular system & hematology ,Risk Assessment ,law.invention ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,law ,Intensive care ,medicine ,Humans ,030212 general & internal medicine ,Hospital Mortality ,Aged ,Retrospective Studies ,Original Paper ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,General Medicine ,Odds ratio ,Early warning score ,Intensive care unit ,Original Papers ,Intensive Care Units ,Infectious Diseases ,Early Warning Score ,Emergency medicine ,Cohort ,Female ,business ,Cohort study - Abstract
Background No risk stratification tool has been validated in hospitalised patients with coronavirus disease 2019 (COVID‐19), despite a high rate of intensive care requirement and in‐hospital mortality. We aimed to determine whether the National Early Warning Score (NEWS) at admission can accurately predict in‐hospital mortality and ICU transfer. Methods This was a retrospective cohort study from January 24 to April 16, 2020, at Lille University Hospital. All consecutive adult patients with laboratory‐confirmed COVID‐19 who were initially admitted to non‐ICU wards were included. The primary outcome was a composite criterion consisting of ICU transfer or in‐hospital mortality. We evaluated the prognostic performance of NEWS by calculating the area under (AUC) the receiver operating characteristic curve, the optimal threshold value of NEWS, and its association with the primary outcome. Results Of the 202 COVID‐19 patients, the median age was 65 (interquartile range 52‐78), 38.6% were women and 136 had at least one comorbidity. The median NEWS was 4 (2‐6). A total of 65 patients were transferred to the ICU or died in the hospital. Compared with patients with favourable outcome, these patients were significantly older, had more comorbidities and higher NEWS. The AUC for NEWS was 0.68 (0.60‐0.77) and the best cutoff value was 6. Adjusted odds ratio for NEWS ≥ 6 as an independent predictor was 3.78 (1.94‐7.09). Conclusions In hospitalised COVID‐19 patients, NEWS was an independent predictor of ICU transfer and in‐hospital death. In daily practice, NEWS ≥ 6 at admission may help to identify patients who are at risk to deteriorate.
- Published
- 2021