Publish in this journal
Journal Information
Share
Share
Download PDF
More article options
ePub
Visits
...
Original article
Available online 30 December 2021
Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients
Validación multicéntrica de Sistemas de Alerta Temprana para la detección precoz de deterioro clínico en pacientes hospitalizados por COVID-19
Visits
...
I.A. Huespea,b,c,
Corresponding author
, I.C. Bissoa, E.S. Romana, E. Pradoa,d, N. Gemellia, J. Sinnera, M.L. Herasa, M.R. Riskb
a Intensive Care Unit, Hospital Italiano de Buenos Aires, Argentina
b Instituto de Medicina Traslacional e Ingeniería Biomédica, HIBA, IUHI, CONICET, Buenos Aires, Argentina
c Internal Medicine Research Unit, Hospital Italiano de Buenos Aires, CABA, Argentina
d Instituto de ciencias aplicadas Sergio Provenzano (ICAP), Facultad de Medicina, Universidad de Buenos Aires, Argentina
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (3)
Table 1. Baseline characteristics of patients at hospital admission.
Table 2. Characteristics of patients 24h before ICU admission. In non-ICU patient's data was compared on the second day of hospitalization.
Table 3. AUROCs and 95% Confidence intervals of the NEWS2, NEWS-C and COVID-19 Severity Index 24 and 48h prior ICU transfer.
Show moreShow less
Additional material (1)
Abstract
Objective

Investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24h.

Design

Retrospective multicenter study.

Setting

Two third-level hospitals in Argentina.

Patients

All adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders.

Interventions

Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization.

Variables

We evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48h, and at hospital admission.

Results

We evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68–0.78) 24h before ICU admission, and 0.52 (95%CI 0.47–0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68–0.78) and 0.52 (95%CI 0.47–0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77–0.84) and 0.61 (95%CI 0.58–0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C.

Conclusion

COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization.

Keywords:
COVID-19
Early Warning Score
SARS-CoV-2
Critical care
Resumen
Objetivo

Investigar el valor predictivo de los scores NEWS2, NEWS-C y COVID-19 Severity Index para predecir la transferencia de urgencia a la unidad de cuidados intensivos (UCI) en las próximas 24horas.

Diseño

Estudio multicéntrico retrospectivo.

Ámbito

Dos hospitales de tercer nivel en Argentina.

Pacientes

Pacientes adultos con COVID-19, ingresados en salas generales, excluyendo pacientes con órdenes de no intubar.

Intervenciones

Se dividió a los pacientes entre los que ingresaron en la UCI y los que no ingresaron. Calculamos las tres puntuaciones para cada día de hospitalización.

Variables

Evaluamos la calibración y discriminación de las tres puntuaciones para predecir el traslado de urgencia a UCI en las 24, 48h previas al pase a UCI y al ingreso hospitalario.

Resultados

Evaluamos 13.768 días de hospitalización en internación general de 1.318 pacientes, de los cuales 126 (9,5%) fueron trasladados a UCI. El AUROC del NEWS2 fue de 0,73 (IC 95% 0,68-0,78) 24h antes del ingreso en UCI y de 0,52 (IC 95% 0,47-0,57) al ingreso hospitalario. El AUROC de NEWS-C fue de 0,73 (IC 95% 0,68-0,78) y 0,52 (IC 95% 0,47-0,57) respectivamente, y el AUROC del COVID-19 Severity Index fue de 0,80 (IC 95% 0,77-0,84) y 0,61 (IC 95% 0,58-0,66) respectivamente. El COVID-19 Severity Index presentó una mejor calibración que NEWS2 y NEWS-C.

Conclusión

El COVID-19 Severity Index presentó una mejor calibración y discriminación que NEWS2 y NEWS-C para predecir la transferencia de la UCI durante la hospitalización.

Palabras clave:
COVID-19
Sistemas de alerta temprana
SARS-CoV-2
Cuidados intensivos

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
Member
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Intensiva (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Medicina Intensiva (English Edition)

Subscribe to our newsletter

es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?