Prognostic value of three rapid scoring scales and combined predictors for the assessment of patients with coronavirus disease 2019.
Hai Hu, Weili Kong, Ni Yao and 2 others
PMID 34080790WHAT IT FOUND
In patients admitted with COVID-19, the REMS score predicted death better than MEWS or RAPS.
Combining scores did not beat REMS. Use it cautiously as an early severity assessment aid, not a proven outcome changer.
Key findings
01REMS had the best ability to predict death, with an AUC of 0.841.
02Combining predictors reached an AUC of 0.878 but did not significantly improve over REMS.
03Age, oxygen saturation level, and lymphocyte count were independent risk factors for mortality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 79 patients from one hospital during an early epidemic, so it may not apply to other settings. The best cut-off scores were chosen from the same data, with no separate validation. Chronic disease details were incomplete, so the effect of specific conditions could not be determined. The study did not test whether using the scores changed patient outcomes.
Declared interests
The authors declared no conflict of interest. The supplied text does not give funding details; the publication types list non-U.S. government research support.
The easy way to misread this
Do not treat REMS as proven to improve care in all settings. It was tested retrospectively in 79 patients from one hospital, and the best cut-offs were chosen from the same data, so the apparent accuracy may be optimistic.