TY - JOUR
T1 - 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
AU - Azijli, Kaoutar
AU - Minderhoud, Tanca
AU - Mohammadi, Parisa
AU - Dekker, Rachelle
AU - Brown, Vanessa
AU - Attaye, Tamana
AU - Huisman, Sebastiaan J.
AU - Hettinga-Roest, Asselina A.
AU - Nanayakkara, Prabath W.B.
N1 - Publisher Copyright: © 2021 Rila Publications Ltd.
PY - 2021/6/6
Y1 - 2021/6/6
N2 - 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.
AB - 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.
KW - Early warning scores
KW - Emergency department
KW - Infection
KW - Risk-stratification
KW - Sepsis
UR - http://www.scopus.com/inward/record.url?scp=85109718127&partnerID=8YFLogxK
U2 - https://doi.org/10.52964/AMJA.0851
DO - https://doi.org/10.52964/AMJA.0851
M3 - Article
C2 - 34190738
SN - 1747-4884
VL - 20
SP - 116
EP - 124
JO - Acute Medicine
JF - Acute Medicine
IS - 2
ER -