Abstract：
BACKGROUND: Early warning scores serve as valuable tools for predicting adverse events in patients. This study aimed to compare the diagnostic performance of National Early Warning Score, Hamilton Early Warning Score, Standardized Early Warning Score, and Triage Early Warning Score in forecasting intubation and mortality among patients with coronavirus disease 2019.
METHODS: This predictive correlation study included 370 patients admitted to the emergency department of 22 Bahman Hospital in Neyshabur, Iran, from December 2021 to March 2022. The aforementioned scores were assessed daily upon patient admission and throughout a 1-month hospitalization period, alongside intubation and mortality occurrences. Data analysis used SPSS 26 and MEDCALC 20.0.13 software. We adhered to the Standards for Reporting of Diagnostic Accuracy Studies guidelines to ensure the accurate reporting of our study.
RESULTS: The patients\' mean age was 65.03 ± 18.47 years, with 209 (56.5%) being male. Both Standardized Early Warning Score and Hamilton Early Warning Score demonstrated high diagnostic performance, with area under the curve values of 0.92 and 0.95, respectively. For Standardized Early Warning Score, the positive likelihood ratio was 10.81 for intubation and 17.90 for mortality, whereas for Hamilton Early Warning Score, the positive likelihood ratio was 7.88 for intubation and 10.40 for mortality. The negative likelihood ratio values were 0.23 and 0.17 for Standardized Early Warning Score and 0.21 and 0.18 for Hamilton Early Warning Score, respectively, for the 24-hour period preceding intubation events and mortality.
CONCLUSIONS: Findings suggest that Standardized Early Warning Score, followed by Hamilton Early Warning Score, has superior diagnostic performance in predicting intubation and mortality in patients with coronavirus disease 2019 within 24 hours before these outcomes. Therefore, serial assessments of Hamilton Early Warning Score or Standardized Early Warning Score may be valuable tools for health care providers in identifying high-risk patients with coronavirus disease 2019 who require intubation or are at increased risk of mortality.
METHODS: This predictive correlation study included 370 patients admitted to the emergency department of 22 Bahman Hospital in Neyshabur, Iran, from December 2021 to March 2022. The aforementioned scores were assessed daily upon patient admission and throughout a 1-month hospitalization period, alongside intubation and mortality occurrences. Data analysis used SPSS 26 and MEDCALC 20.0.13 software. We adhered to the Standards for Reporting of Diagnostic Accuracy Studies guidelines to ensure the accurate reporting of our study.
RESULTS: The patients\' mean age was 65.03 ± 18.47 years, with 209 (56.5%) being male. Both Standardized Early Warning Score and Hamilton Early Warning Score demonstrated high diagnostic performance, with area under the curve values of 0.92 and 0.95, respectively. For Standardized Early Warning Score, the positive likelihood ratio was 10.81 for intubation and 17.90 for mortality, whereas for Hamilton Early Warning Score, the positive likelihood ratio was 7.88 for intubation and 10.40 for mortality. The negative likelihood ratio values were 0.23 and 0.17 for Standardized Early Warning Score and 0.21 and 0.18 for Hamilton Early Warning Score, respectively, for the 24-hour period preceding intubation events and mortality.
CONCLUSIONS: Findings suggest that Standardized Early Warning Score, followed by Hamilton Early Warning Score, has superior diagnostic performance in predicting intubation and mortality in patients with coronavirus disease 2019 within 24 hours before these outcomes. Therefore, serial assessments of Hamilton Early Warning Score or Standardized Early Warning Score may be valuable tools for health care providers in identifying high-risk patients with coronavirus disease 2019 who require intubation or are at increased risk of mortality.
摘要：
背景：早期预警评分是预测患者不良事件的有价值的工具。本研究旨在比较国家早期预警评分的诊断性能，汉密尔顿预警评分,标准化预警评分,和分流预警评分预测2019年冠状病毒病患者插管和死亡率。
方法：这项预测性相关性研究包括内沙布尔22Bahman医院急诊科收治的370名患者，伊朗,从2021年12月到2022年3月。上述评分在患者入院时每天进行评估，并在整个1个月的住院期间进行评估。除了插管和死亡率发生。数据分析采用SPSS26和MEDCALC20.0.13软件。我们遵守诊断准确性研究报告标准指南，以确保我们的研究报告准确。
结果：患者的平均年龄为65.03±18.47岁，209人（56.5%）为男性。标准化预警评分和汉密尔顿预警评分均表现出较高的诊断性能，曲线下面积值分别为0.92和0.95。对于标准化预警评分，插管阳性似然比为10.81,死亡率为17.90,而对于汉密尔顿预警评分，插管阳性似然比为7.88,死亡率为10.40.标准化预警评分的负似然比值为0.23和0.17，汉密尔顿预警评分的负似然比值为0.21和0.18，分别,在插管事件和死亡率之前的24小时内。
结论：研究结果表明，标准化预警评分，其次是汉密尔顿预警评分,在预测2019年冠状病毒病患者在这些结局前24小时内的插管和死亡率方面具有优异的诊断性能。因此,汉密尔顿预警评分或标准化预警评分的系列评估可能是医疗保健提供者识别2019年冠状病毒疾病高危患者的有价值的工具,这些患者需要插管或死亡风险增加.
方法：这项预测性相关性研究包括内沙布尔22Bahman医院急诊科收治的370名患者，伊朗,从2021年12月到2022年3月。上述评分在患者入院时每天进行评估，并在整个1个月的住院期间进行评估。除了插管和死亡率发生。数据分析采用SPSS26和MEDCALC20.0.13软件。我们遵守诊断准确性研究报告标准指南，以确保我们的研究报告准确。
结果：患者的平均年龄为65.03±18.47岁，209人（56.5%）为男性。标准化预警评分和汉密尔顿预警评分均表现出较高的诊断性能，曲线下面积值分别为0.92和0.95。对于标准化预警评分，插管阳性似然比为10.81,死亡率为17.90,而对于汉密尔顿预警评分，插管阳性似然比为7.88,死亡率为10.40.标准化预警评分的负似然比值为0.23和0.17，汉密尔顿预警评分的负似然比值为0.21和0.18，分别,在插管事件和死亡率之前的24小时内。
结论：研究结果表明，标准化预警评分，其次是汉密尔顿预警评分,在预测2019年冠状病毒病患者在这些结局前24小时内的插管和死亡率方面具有优异的诊断性能。因此,汉密尔顿预警评分或标准化预警评分的系列评估可能是医疗保健提供者识别2019年冠状病毒疾病高危患者的有价值的工具,这些患者需要插管或死亡风险增加.
