Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments

Martin-Rodríguez, Francisco; Conty, José Luis Martín; Sanz-García, Áncor; Rodríguez, Virginia Carbajosa; Ortega, Guillermo; Ruíz, Irene Cebrían Cebrían; Ramos, José R. Oliva; Portillo, Enrique Castro; Polonio-López, Begoña; Gambarra, Rodrigo Enríquez de Salamanca; Pérez, Marta Gómez-Escolar; López-Izquierdo, Raúl

doi:10.3390/jpm11030170

Cited by 20 publications

(33 citation statements)

References 52 publications

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“… 8 Martín-Rodriguez et al observed that the NEWS2 at hospital admission was the scale with the best capacity to predict early mortality (less than 48 hrs after hospital admission). 12 Su et al found an AUROC of 0.89 (IC95% 0.82–0.96) for NEWS-C score predicting deterioration of the respiratory function and need of intensive respiratory support. 4 Socio et al and Hai Hu et al reported an AUROC of 0.87 and 0.81 respectively for NEWS2 score to predict death at hospital admission.…”

Section: Discussionmentioning

confidence: 99%

Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients

Huespe¹,

Bisso²,

Román³

et al. 2023

Medicina Intensiva (English Edition)

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Section: Discussionmentioning

confidence: 99%

Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients

Huespe¹,

Bisso²,

Román³

et al. 2023

Medicina Intensiva (English Edition)

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“…National Early Warning Score (NEWS) (1,2,3,4,19,20,21,24,25) FC * , FR € , PAS § , T ∑ , SaO2 £ , uso del dispositivo de oxígeno y nivel de conciencia. National Early Warning Score 2 (NEWS2) (15,16,17,18,19,20,21,22) FC * , FR € , PAS § , T ∑ , SaO2 £ , nivel de conciencia y el uso de oxígeno auxiliar, y una evaluación específica para los pacientes con insuficiencia respiratoria hipercápnica. Quick Sepsis Related Organ Failure Assessment (qSOFA) (2,15,16,18,19,20,22,24,25) FR € , PAS § y nivel de conciencia Modified Early Warning Score (MEWS) (4,14,20,24,27,29,30) FC * , FR € , PAS § , T ∑ y nivel de conciencia Rapid Emergency Medicine Score (REMS) (2,4,19) FC * , FR € , PAS § , SaO2 £ , edad y nivel de conciencia.…”

Section: Instrumento Parámetros De Evaluaciónunclassified

Escalas de alerta precoce para rastrear deterioração clínica em serviços médicos de emergência: revisão integrativa

et al. 2022

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Objective: To identify the scientific evidence in the literature on the use of early warning scales in the identification of adult and elderly patients in clinical deterioration in emergency medical services.Methods: Integrative review, supported by the recommendation Preferred Reporting Items for Systematic Reviews and Meta-Analyses, with a search mnemonic based on the Populacion - Interest Phenomenon - Context (PICo) strategy, performed in the sources: US National Library of Medicine National Institutes Database Search of Health, Web of Science, SciVerse Scopus, Latin American and Caribbean Literature in Health Sciences and Cumulative Index to Nursing and Allied Health Literature. Rayyan was used in selection and content analysis to analyze the findings.Results: 691 articles were identified, of which 22 composed the sample and 27 scales were listed, with emphasis on the National Early Warning Score, National Early Warning Score 2, Quick Sepsis Related Organ Failure Assessment and Modified Early Warning Score. The scales had similar assessment parameters, characterized by heart rate, respiratory rate, systolic blood pressure, temperature, oxygen saturation and level of consciousness.Conclusion: 27 scales were listed with similar evaluation parameters, in which four were the most prevalent and of these the National Early Warning Score proved to be the most accurate, however evidence shows that the Modified Early Warning Score is the most used in emergency medical services. Objetivo: Identificar la evidencia científica en la literatura sobre el uso de escalas de alerta temprana en la identificación de pacientes adultos y ancianos en deterioro clínico en servicios médicos de emergencia.Métodos: Revisión integradora, apoyada por la recomendación Preferred Reporting Items for Systematic Reviews and Meta-Analyses, con una estrategia de búsqueda basada en la mnemotécnica Población - Fenómeno de interés - Contexto (PICo), realizada en las fuentes: US National Library of Medicine National Institutes Database Search of Health, Web of Science, SciVerse Scopus, Literatura Latino-americana e do Caribe em Ciências da Saúde e Cumulative Index to Nursing and Allied Health Literature. Rayyan se utilizó en la selección y el análisis de contenido para analizar los hallazgos.Resultados: Se identificaron 691 artículos, de los cuales 22 compusieron la muestra y se enumeraron 27 escalas, National Early Warning Score, National Early Warning Score 2, Quick Sepsis Related Organ Failure Assessment e Modified Early Warning Score. Las escalas tenían parámetros de evaluación similares, caracterizados por frecuencia cardíaca, frecuencia respiratoria, presión arterial sistólica, temperatura, saturación de oxígeno y nivel de conciencia.Conclusión: Se enumeraron 27 escalas con parámetros de evaluación similares, en las cuales cuatro fueron las más prevalentes y de estas la National Early Warning Score resultó ser la más precisa, sin embargo, la evidencia muestra que la Modified Early Warning Score es la más utilizada en servicios médicos de emergencia. Objetivo: Identificar as evidências científicas existentes na literatura sobre o uso de escalas de alerta precoce na identificação de pacientes adultos e idosos em deterioração clínica nos serviços médicos de emergência.Métodos: Revisão integrativa sustentada pela recomendação Preferred Reporting Items for Systematic Reviews and Meta-Analyses, com estratégia de busca fundamentada no mnemônico Populacion - Interest Phenomenon - Context (PICo), realizada nas fontes: US National Library of Medicine National Institutes Database Search of Health, Web of Science, SciVerse Scopus, Literatura Latino-americana e do Caribe em Ciências da Saúde e Cumulative Index to Nursing and Allied Health Literature. Utilizou-se o Rayyan na seleção e a análise de conteúdo para análise dos achados.Resultados: Identificaram-se 691 artigos, destes, 22 compuseram a amostra e elencaram-se 27 escalas, com destaque para a National Early Warning Score, National Early Warning Score 2, Quick Sepsis Related Organ Failure Assessment e Modified Early Warning Score. As escalas possuíam parâmetros de avaliação semelhantes, caracterizados pela frequência cardíaca, frequência respiratória, pressão arterial sistólica, temperatura, saturação de oxigênio e nível de consciência.Conclusão: Elencaram-se 27 escalas com parâmetros de avaliação semelhantes, das quais quatro foram as mais prevalentes e, destas, a National Early Warning Score demonstrou ser a mais precisa. No entanto, as evidências demonstram que a Modified Early Warning Score é a mais utilizada nos serviços médicos de emergência.

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“…Patients must therefore be frequently assessed in terms of intensive care unit (ICU) requirements. Several scoring systems for evaluating severity of disease 2,3 and a number of thoracic computed tomography (CT) algorithms for assessing pulmonary involvement 4 have been developed. However, CT is not suitable for repeated use since it requires the patient to be moved to other areas and involves exposure to radiation 5 .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the CLUE protocol in COVID-19 triage

Acar

Yamanoğlu

Arıkan

et al. 2022

Cukurova Medical Journal

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Purpose: The purpose of this study was to evaluate the effectiveness of the CLUE protocol in COVID-19 triage. Materials and Methods: Patients who presented to the emergency department due to dyspnea with oxygen saturation below 95 % and were diagnosed with COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) tests were included in this prospective, observational study. Patients included in the study underwent lung ultrasound (LUS) in the light of the CLUE protocol, and were accordingly given LUS scores of between 0 and 36, also within the scope of the protocol. Patients were placed under observation, and clinical outcomes of discharge from the emergency department, admission to the ward, and admission to intensive care or discharge were recorded. ROC analysis was applied in the calculation of threshold values for LUS scores predicting discharge, admission to intensive care, and mortality. Results: Forty-five patients with a mean age of 63 ± 18 years were included in the study. Fifteen patients (33 %) were treated on an outpatient basis and discharged, while 12 (27 %) were admitted to the ward and 18 (40 %) to the intensive care unit. Mortality occurred in 15 (33 %) patients. An LUS score lower than 3 was 97 % sensitive and 80 % specific for discharge, a score greater than 10 was 94 % sensitive and 78 % specific for admission to the intensive care unit, and a score higher than 11 was 93 % sensitive and 87 % specific for mortality. Based on regression analysis, an LUS score higher than 10 emerged as an independent risk factor for intensive care requirement, a score lower than 3 for discharge, and a score over 11 for mortality. Conclusion: The CLUE protocol may be a useful bedside test in COVID-19 triage, and one that does not involve radiation or require laboratory tests.

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Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments

Cited by 20 publications

References 52 publications

Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients

Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients

Escalas de alerta precoce para rastrear deterioração clínica em serviços médicos de emergência: revisão integrativa

Effectiveness of the CLUE protocol in COVID-19 triage

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