One-on-one comparison between qCSI and NEWS scores for mortality risk assessment in patients with COVID-19

Article Subjects > Biomedicine Ibero-american International University > Research > Articles and Books Open English Objective To compare the predictive value of the quick COVID-19 Severity Index (qCSI) and the National Early Warning Score (NEWS) for 90-day mortality amongst COVID-19 patients. Methods Multicenter retrospective cohort study conducted in adult patients transferred by ambulance to an emergency department (ED) with suspected COVID-19 infection subsequently confirmed by a SARS-CoV-2 test (polymerase chain reaction). We collected epidemiological data, clinical covariates (respiratory rate, oxygen saturation, systolic blood pressure, heart rate, temperature, level of consciousness and use of supplemental oxygen) and hospital variables. The primary outcome was cumulative all-cause mortality during a 90-day follow-up, with mortality assessment monitoring time points at 1, 2, 7, 14, 30 and 90 days from ED attendance. Comparison of performances for 90-day mortality between both scores was carried out by univariate analysis. Results From March to November 2020, we included 2,961 SARS-CoV-2 positive patients (median age 79 years, IQR 66–88), with 49.2% females. The qCSI score provided an AUC ranging from 0.769 (1-day mortality) to 0.749 (90-day mortality), whereas AUCs for NEWS ranging from 0.825 for 1-day mortality to 0.777 for 90-day mortality. At all-time points studied, differences between both scores were statistically significant (p < .001). Conclusion Patients with SARS-CoV-2 can rapidly develop bilateral pneumonias with multiorgan disease; in these cases, in which an evacuation by the EMS is required, reliable scores for an early identification of patients with risk of clinical deterioration are critical. The NEWS score provides not only better prognostic results than those offered by qCSI at all the analyzed time points, but it is also better suited for COVID-19 patients. metadata Martín-Rodríguez, Francisco; Sanz-García, Ancor; Ortega, Guillermo J.; Delgado-Benito, Juan F.; Garcia Villena, Eduardo; Mazas Pérez-Oleaga, Cristina; López-Izquierdo, Raúl and Castro Villamor, Miguel A. mail UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, eduardo.garcia@uneatlantico.es, cristina.mazas@uneatlantico.es, UNSPECIFIED, UNSPECIFIED (2022) One-on-one comparison between qCSI and NEWS scores for mortality risk assessment in patients with COVID-19. Annals of Medicine, 54 (1). pp. 646-654. ISSN 0785-3890

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Abstract

Objective To compare the predictive value of the quick COVID-19 Severity Index (qCSI) and the National Early Warning Score (NEWS) for 90-day mortality amongst COVID-19 patients. Methods Multicenter retrospective cohort study conducted in adult patients transferred by ambulance to an emergency department (ED) with suspected COVID-19 infection subsequently confirmed by a SARS-CoV-2 test (polymerase chain reaction). We collected epidemiological data, clinical covariates (respiratory rate, oxygen saturation, systolic blood pressure, heart rate, temperature, level of consciousness and use of supplemental oxygen) and hospital variables. The primary outcome was cumulative all-cause mortality during a 90-day follow-up, with mortality assessment monitoring time points at 1, 2, 7, 14, 30 and 90 days from ED attendance. Comparison of performances for 90-day mortality between both scores was carried out by univariate analysis. Results From March to November 2020, we included 2,961 SARS-CoV-2 positive patients (median age 79 years, IQR 66–88), with 49.2% females. The qCSI score provided an AUC ranging from 0.769 (1-day mortality) to 0.749 (90-day mortality), whereas AUCs for NEWS ranging from 0.825 for 1-day mortality to 0.777 for 90-day mortality. At all-time points studied, differences between both scores were statistically significant (p < .001). Conclusion Patients with SARS-CoV-2 can rapidly develop bilateral pneumonias with multiorgan disease; in these cases, in which an evacuation by the EMS is required, reliable scores for an early identification of patients with risk of clinical deterioration are critical. The NEWS score provides not only better prognostic results than those offered by qCSI at all the analyzed time points, but it is also better suited for COVID-19 patients.

Document Type: Article
Keywords: Clinical decision rules COVID-19 Risk Scores NEWS, qCSI
Subject classification: Subjects > Biomedicine
Divisions: Ibero-american International University > Research > Articles and Books
Deposited: 03 Mar 2022 13:06
Last Modified: 03 Mar 2022 13:06
URI: https://repositorio.unib.org/id/eprint/512

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