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[Probability of acute heart failure in chronic kidney disease].

Revista medica del Instituto Mexicano del Seguro Social·2022
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[COVID-19 mortality prediction. Comparison between two scales].

Alberto Arce-Zepeda1, Armando Geovanni Araiza-Aguirre2

  • 1Instituto Mexicano del Seguro Social, Hospital General Regional No. 46, Coordinación Clínica de Educación e Investigación en Salud. Guadalajara, Jalisco, México.

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PubMed
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The National Early Warning Score 2 (NEWS2) and Rapid Emergency Medicine Score (REMS) effectively predict COVID-19 mortality. NEWS2 demonstrated slightly superior predictive performance compared to REMS in this patient cohort.

Keywords:
Coronavirus InfectionsEmergency MedicineHospital Mortality

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Area of Science:

  • Emergency Medicine
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Prognosis and mortality in COVID-19 patients vary significantly.
  • National Early Warning Score 2 (NEWS2) and Rapid Emergency Medicine Score (REMS) are used for rapid mortality prediction upon hospital admission.
  • No prior studies have directly compared the predictive performance of NEWS2 and REMS in this specific population.

Purpose of the Study:

  • To conduct a comparative analysis of the predictive accuracy of NEWS2 and REMS for mortality in COVID-19 patients.
  • To evaluate the performance metrics including Area Under the Curve (AUC), sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) for both scoring systems.

Main Methods:

  • A retrospective cohort study involving 361 COVID-19 patients.
  • Collection of variables to calculate NEWS2 and REMS scores at admission.
  • Analysis of mortality prediction using Receiver Operating Characteristic (ROC) curves and calculation of AUC with 95% confidence intervals (CI).
  • Determination of optimal cut-off points (PC) and relative risk (RR) for mortality.

Main Results:

  • NEWS2 achieved an AUC of 0.929 (95% CI: 0.903-0.956), while REMS achieved an AUC of 0.913 (95% CI: 0.884-0.943).
  • Optimal cut-off points were 8 for NEWS2 (sensitivity 87.8%, specificity 82.1%) and 7 for REMS (sensitivity 83.5%, specificity 83.7%).
  • NEWS2 showed a higher relative risk (RR) for mortality (10.74) compared to REMS (8.36) at their respective cut-off points.

Conclusions:

  • Both NEWS2 and REMS exhibit strong discriminative ability for predicting mortality in COVID-19 patients.
  • The NEWS2 scale demonstrated superior predictive performance based on AUC and RR compared to the REMS scale.
  • NEWS2 is a valuable tool for early risk stratification of COVID-19 patients.