COVID-19 mortality prediction. Comparison between two scales
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Keywords
Hospital Mortality, Emergency Medicine, Coronavirus Infections
Abstract
Background: The prognosis and mortality in patients with COVID-19 are variable. The NEWS2 (National Early Warning Score) and REMS (Rapid Emergency Medicine Score) scales can be used quickly at hospital admission to predict mortality, no studies have been found that compare their predictive performance in our population.
Objective: To compare NEWS2 and REMS to predict mortality in patients with COVID-19.
Material and methods: Retrospective cohort with 361 patients. The variables were collected to calculate the NEWS2 and REMS scales and the reason for hospital discharge. The predictive value for mortality was analyzed using the ROC curve, establishing the area under the curve (AUC) with 95% confidence intervals (95% CI). The cut-off point (PC) with the best sensitivity and specificity, positive predictive value (PPV) and negative predictive value (NPV), as well as relative risk (RR) with 95% CI.
Results: The AUC of NEWS2 and REMS were 0.929 (95% CI: 0.903-0.956) and 0.913 (95% CI: 0.884-0.943), respectively. The PC of the NEWS2 scale was 8 points, with sensitivity 87.8% and specificity 82.1%, PPV 69.7% and NPV 93.5% and of the REMS scale of 7 points, with sensitivity 83.5% and specificity 83.7%, PPV 70.5% and NPV 91.6%. 8 or more points on the NEWS2 scale presenting a RR of 10.74 (95% CI: 6.4-18.03), and REMS 7 or more points RR 8.36 (95% CI: 5.36-13.02)
Conclusion: Both tests presented good discriminative ability to predict mortality, being better according to AUC and RR in the NEWS2 scale.
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