National early warning score to predict intensive care unit transfer and mortality in COVID‐19 in a French cohort

Background No risk stratification tool has been validated in hospitalised patients with coronavirus disease 2019 (COVID‐19), despite a high rate of intensive care requirement and in‐hospital mortality. We aimed to determine whether the National Early Warning Score (NEWS) at admission can accurately...

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Published in:International journal of clinical practice (Esher) 2021-06, Vol.75 (6), p.e14121-n/a
Main Authors: Pokeerbux, Mohammad Ryadh, Yelnik, Cécile M., Faure, Emmanuel, Drumez, Elodie, Bruandet, Amélie, Labreuche, Julien, Assaf, Ady, Goffard, Anne, Garabedian, Charles, Poissy, Julien, Desbordes, Jacques, Garrigue, Delphine, Scherpereel, Arnaud, Faure, Karine, Lambert, Marc
Format: Article
Language:English
Subjects:
Coronaviruses
COVID-19
Intensive care
Life Sciences
Mortality
Original Paper
Original Papers
Vital signs
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Summary:Background No risk stratification tool has been validated in hospitalised patients with coronavirus disease 2019 (COVID‐19), despite a high rate of intensive care requirement and in‐hospital mortality. We aimed to determine whether the National Early Warning Score (NEWS) at admission can accurately predict in‐hospital mortality and ICU transfer. Methods This was a retrospective cohort study from January 24 to April 16, 2020, at Lille University Hospital. All consecutive adult patients with laboratory‐confirmed COVID‐19 who were initially admitted to non‐ICU wards were included. The primary outcome was a composite criterion consisting of ICU transfer or in‐hospital mortality. We evaluated the prognostic performance of NEWS by calculating the area under (AUC) the receiver operating characteristic curve, the optimal threshold value of NEWS, and its association with the primary outcome. Results Of the 202 COVID‐19 patients, the median age was 65 (interquartile range 52‐78), 38.6% were women and 136 had at least one comorbidity. The median NEWS was 4 (2‐6). A total of 65 patients were transferred to the ICU or died in the hospital. Compared with patients with favourable outcome, these patients were significantly older, had more comorbidities and higher NEWS. The AUC for NEWS was 0.68 (0.60‐0.77) and the best cutoff value was 6. Adjusted odds ratio for NEWS ≥ 6 as an independent predictor was 3.78 (1.94‐7.09). Conclusions In hospitalised COVID‐19 patients, NEWS was an independent predictor of ICU transfer and in‐hospital death. In daily practice, NEWS ≥ 6 at admission may help to identify patients who are at risk to deteriorate.
ISSN:1368-5031
1742-1241
1742-1241
DOI:10.1111/ijcp.14121