tetano
Editor, Senior Moderator
Int J Clin Pract
. 2021 Mar 1;e14121.
doi: 10.1111/ijcp.14121. Online ahead of print.
National early warning score to predict intensive care unit transfer and mortality in COVID-19 in a French cohort
Mohammad Ryadh Pokeerbux[SUP] 1 [/SUP], C?cile M Yelnik[SUP] 1 [/SUP], Emmanuel Faure[SUP] 2 [/SUP], Elodie Drumez[SUP] 3 [/SUP], Am?lie Bruandet[SUP] 4 [/SUP], Julien Labreuche[SUP] 3 [/SUP], Ady Assaf[SUP] 2 [/SUP], Anne Goffard[SUP] 5 [/SUP], Charles Garabedian[SUP] 6 [/SUP], Julien Poissy[SUP] 7 [/SUP], Jacques Desbordes[SUP] 8 [/SUP], Delphine Garrigue[SUP] 9 [/SUP], Arnaud Scherpereel[SUP] 10 [/SUP], Karine Faure[SUP] 2 [/SUP], Marc Lambert[SUP] 1 [/SUP], Lille Covid-Team
Affiliations
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 criteria 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, 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 to 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.
Keywords: National Early Warning Score; coronavirus disease 2019; intensive care unit transfer; mortality; prognosis; severe acute respiratory syndrome coronavirus 2.
. 2021 Mar 1;e14121.
doi: 10.1111/ijcp.14121. Online ahead of print.
National early warning score to predict intensive care unit transfer and mortality in COVID-19 in a French cohort
Mohammad Ryadh Pokeerbux[SUP] 1 [/SUP], C?cile M Yelnik[SUP] 1 [/SUP], Emmanuel Faure[SUP] 2 [/SUP], Elodie Drumez[SUP] 3 [/SUP], Am?lie Bruandet[SUP] 4 [/SUP], Julien Labreuche[SUP] 3 [/SUP], Ady Assaf[SUP] 2 [/SUP], Anne Goffard[SUP] 5 [/SUP], Charles Garabedian[SUP] 6 [/SUP], Julien Poissy[SUP] 7 [/SUP], Jacques Desbordes[SUP] 8 [/SUP], Delphine Garrigue[SUP] 9 [/SUP], Arnaud Scherpereel[SUP] 10 [/SUP], Karine Faure[SUP] 2 [/SUP], Marc Lambert[SUP] 1 [/SUP], Lille Covid-Team
Affiliations
- PMID: 33650136
- DOI: 10.1111/ijcp.14121
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 criteria 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, 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 to 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.
Keywords: National Early Warning Score; coronavirus disease 2019; intensive care unit transfer; mortality; prognosis; severe acute respiratory syndrome coronavirus 2.