Assessment of the performance of early warning scores in patients with COVID-19.
Victoria Castilho Bartolomeu, Luiz Humberto Vieri Piacezzi, Karina Aparecida Lopes da Costa and 3 others
PMID 40434111WHAT IT FOUND
The NEWS-based scores caught more deterioration, ICU admission and death, but also produced many false alarms.
MEWS and qSOFA were better at confirming patients were not deteriorating.
Key findings
01NEWS 2 and NEWS A showed high sensitivity for acute respiratory failure and shock.
02MEWS and qSOFA showed superior specificity for acute respiratory failure and death.
03Kappa agreement with clinical deterioration was 0.269 for qSOFA and MEWS and 0.677 for NEWS 2 and NEWS A.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done at one hospital and looked back at records, so the results may not apply to other emergency services or patient groups. Some records were incomplete for calculating the scores, which could change how well the scores performed. The study measured how well admission scores matched outcomes that had already happened. It did not test whether using the scores improved patient care or mortality. The patients were mostly men, white and had incomplete elementary education, and many had comorbidities, so the findings may not fit all patients.
Declared interests
The study was financed in part by CNPq in Brazil.
The easy way to misread this
Do not read a high NEWS-based score as proof that a patient will deteriorate or needs ICU care. These scores were sensitive but not specific, so they flagged many patients who did not deteriorate, and the study did not show that using them improved outcomes.