COVID-19: Association of risk classification with the Modified Early Warning Score and hospital outcomes.
Alexandra Emidio Neiman, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes and 2 others
PMID 37729245WHAT IT FOUND
Nurses' color-based triage at a Brazilian emergency unit aligned with MEWS severity: red-category patients had higher MEWS, more early deterioration, and more deaths.
MEWS may help monitor high-risk COVID-19 patients, but this is a link, not a treatment effect.
Key findings
01Red-category patients had higher MEWS scores and more MEWS >4 than other risk categories.
02Most deterioration within 24 hours occurred in red-category patients; yellow and orange deteriorated later than blue/green.
03Red-category patients had lower discharge and higher death than blue/green, yellow and orange.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All patients came from one emergency unit in São Paulo, so results may not apply to other hospitals. The study looked backward at records and did not test whether using MEWS changed care or outcomes. Risk classification used one local protocol, so other hospitals may classify patients differently. Some patient data were missing or not reported, including schooling and final outcomes.
The easy way to misread this
Do not read this as proof that MEWS improves outcomes. It is a retrospective record review showing that red triage categories had higher MEWS and worse outcomes; it did not test whether using MEWS changed care or mortality.