International Journal of Critical Illness and Injury Science

ORIGINAL ARTICLE
Year
: 2022  |  Volume : 12  |  Issue : 3  |  Page : 133--137

Utility of National Early Warning Score 2 to risk-stratify coronavirus disease of 2019 patients in the emergency department: A retrospective cohort study


Sweta Khuraijam, Alok Gangurde, Vridhi Shetty 
 Department of Emergency Medicine, Dr. D.Y. Patil Medical College, Dr. D.Y.Patil Vidyapeeth, Pune, Maharashtra, India

Correspondence Address:
Dr. Sweta Khuraijam
Department of Emergency Medicine, Dr. D.Y. Patil Medical College, Sant Tukaram Nagar, Pimpri, Pune - 411 018, Maharashtra
India

Background: The application of a risk stratification pathway is necessary for the emergency department (ED) to assess the severity of the disease and the need for escalation of therapy. We aimed to implement the National Early Warning Score 2 (NEWS2) pathway at triage to differentiate patients who are stable or critically ill with no invasive investigations at the time of admission during the coronavirus disease of 2019 (COVID-19) era in comparison to other clinical risk scores. Methods: One hundred and four patients were collected from April 1, 2021, to June 1, 2021, during the second wave of the COVID-19 pandemic at an academic medical center in India. The NEWS2 scoring system and the quick sepsis-related organ failure assessment (qSOFA) score were introduced as part of the initial assessment in the triage area of the ED. Data were assessed using the area under the receiving operating characteristic (AUROC) curve for NEWS2 and qSOFA scores, respectively. Results: In the study, NEWS2 classification indicated that 25% of patients required continuous monitoring, of which 12.7% subsequently deteriorated within 24 h of admission and 7% died. Both, NEWS2 (threshold 0; 1, AUROC 0.883; 95%; confidence interval [CI] 0.8–0.966) and qSOFA (threshold 0; 1, AUROC 0.851; 95% CI 0.766–29 0.936) effectively identified COVID-19 patients in the ED at risk for clinical deterioration. There was no significant difference in the diagnostic performance of qSOFA and NEWS2 (DeLong's test P = 0.312). Conclusion: Both NEWS2 and qSOFA effectively-identified COVID-19 patients in the ED at risk for clinical deterioration with no significant statistical difference. However, a triage level risk stratification score can be developed with the inclusion of blood parameters on admission to further validate the practice.


How to cite this article:
Khuraijam S, Gangurde A, Shetty V. Utility of National Early Warning Score 2 to risk-stratify coronavirus disease of 2019 patients in the emergency department: A retrospective cohort study.Int J Crit Illn Inj Sci 2022;12:133-137


How to cite this URL:
Khuraijam S, Gangurde A, Shetty V. Utility of National Early Warning Score 2 to risk-stratify coronavirus disease of 2019 patients in the emergency department: A retrospective cohort study. Int J Crit Illn Inj Sci [serial online] 2022 [cited 2022 Sep 26 ];12:133-137
Available from: https://www.ijciis.org/article.asp?issn=2229-5151;year=2022;volume=12;issue=3;spage=133;epage=137;aulast=Khuraijam;type=0