Predicting Mortality for COVID-19 Patients Admitted to an Emergency Department Using Early Warning Scores in Poland

• Published in: Healthcare (Basel) Vol. 12; no. 6; p. 687
• Main Authors: Rzońca, Patryk, Butkiewicz, Sławomir, Dobosz, Paula, Zaczyński, Artur, Podgórski, Marcin, Gałązkowski, Robert, Wierzba, Waldemar, Życińska, Katarzyna
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.03.2024; MDPI
• Subjects: Blood pressure; Chronic obstructive pulmonary disease; COVID-19; Disease transmission; Dyspnea; early warning score; emergency department; Emergency medical care; Hospitalization; Hospitals; Intensive care; Mortality; outcome; Oxygen therapy; Pandemics; Patients; Pneumonia; Respiratory failure; Risk factors; Severe acute respiratory syndrome coronavirus 2; Software; Ventilators; Vital signs; Poland; COVID-19; mortality; emergency department; early warning score; outcome
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare12060687

COVID-19 disease is characterised by a wide range of symptoms that in most cases resemble flu or cold. Early detection of infections, monitoring of patients' conditions, and identification of patients with worsening symptoms became crucial during the peak of pandemic. The aim of this study was to assess and compare the performance of common early warning scores at the time of admission to an emergency department in predicting in-hospital mortality in patients with COVID-19. The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to an emergency department between March 2020 and April 2022. The prognostic value of early warning scores in predicting in-hospital mortality was assessed using the receiver operating characteristic (ROC) curve. Patients' median age was 59 years, and 52.33% were male. Among all the EWS we assessed, REMS had the highest overall accuracy (AUC 0.84 (0.83-0.85)) and the highest NPV (97.4%). REMS was the most accurate scoring system, characterised by the highest discriminative power and negative predictive value compared to the other analysed scoring systems. Incorporating these tools into clinical practice in a hospital emergency department could provide more effective assessment of mortality and, consequently, avoid delayed medical assistance.