Performance of NEWS, qSOFA, and SIRS Scores for Assessing Mortality, Early Bacterial Infection, and Admission to ICU in COVID-19 Patients in the Emergency Department

Alencar, Júlio César Garcia de; Gómez, Luz Marina Gómez; Cortez, André Lazzeri; Souza, Heraldo Possolo de; Levin, Anna Sara Shafferman; Salomão, Matias Chiarastelli

doi:10.3389/fmed.2022.779516

Cited by 15 publications

(12 citation statements)

References 34 publications

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“…In agreement with our analysis, most studies report poor performance of the qSOFA as a mortality prediction tool11 38–45 and as an ICU-admission predictor25 32 43–46 for patients with COVID-19. This may be explained by the fact that, in contrast with bacterial CAP, circulatory failure occurs seldomly in patients with COVID-19, and outcomes are mainly determined by the severity of AHRF, age and comorbid conditions which are poorly taken into account in qSOFA.…”

Section: Discussionsupporting

confidence: 89%

Comparison of prognostic scores for inpatients with COVID-19: a retrospective monocentric cohort study

et al. 2022

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BackgroundThe SARS-CoV-2 pandemic led to a steep increase in hospital and intensive care unit (ICU) admissions for acute respiratory failure worldwide. Early identification of patients at risk of clinical deterioration is crucial in terms of appropriate care delivery and resource allocation. We aimed to evaluate and compare the prognostic performance of Sequential Organ Failure Assessment (SOFA), Quick Sequential Organ Failure Assessment (qSOFA), Confusion, Uraemia, Respiratory Rate, Blood Pressure and Age ≥65 (CURB-65), Respiratory Rate and Oxygenation (ROX) index and Coronavirus Clinical Characterisation Consortium (4C) score to predict death and ICU admission among patients admitted to the hospital for acute COVID-19 infection.Methods and analysisConsecutive adult patients admitted to the Geneva University Hospitals during two successive COVID-19 flares in spring and autumn 2020 were included. Discriminative performance of these prediction rules, obtained during the first 24 hours of hospital admission, were computed to predict death or ICU admission. We further exluded patients with therapeutic limitations and reported areas under the curve (AUCs) for 30-day mortality and ICU admission in sensitivity analyses.ResultsA total of 2122 patients were included. 216 patients (10.2%) required ICU admission and 303 (14.3%) died within 30 days post admission. 4C score had the best discriminatory performance to predict 30-day mortality (AUC 0.82, 95% CI 0.80 to 0.85), compared with SOFA (AUC 0.75, 95% CI 0.72 to 0.78), qSOFA (AUC 0.59, 95% CI 0.56 to 0.62), CURB-65 (AUC 0.75, 95% CI 0.72 to 0.78) and ROX index (AUC 0.68, 95% CI 0.65 to 0.72). ROX index had the greatest discriminatory performance (AUC 0.79, 95% CI 0.76 to 0.83) to predict ICU admission compared with 4C score (AUC 0.62, 95% CI 0.59 to 0.66), CURB-65 (AUC 0.60, 95% CI 0.56 to 0.64), SOFA (AUC 0.74, 95% CI 0.71 to 0.77) and qSOFA (AUC 0.59, 95% CI 0.55 to 0.62).ConclusionScores including age and/or comorbidities (4C and CURB-65) have the best discriminatory performance to predict mortality among inpatients with COVID-19, while scores including quantitative assessment of hypoxaemia (SOFA and ROX index) perform best to predict ICU admission. Exclusion of patients with therapeutic limitations improved the discriminatory performance of prognostic scores relying on age and/or comorbidities to predict ICU admission.

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Section: Discussionsupporting

confidence: 89%

Comparison of prognostic scores for inpatients with COVID-19: a retrospective monocentric cohort study

et al. 2022

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“…However, neither Brixia score nor qSOFA score in one particular day could predict the radiological or clinical evolution of the patient during the next days, in either spring or autumn patients. This is in accordance with Cagino [ 52 ], Heldt [ 53 ] and Alencar [ 54 ], who found no correlation between qSOFA score and outcomes in pregnant or nonpregnant COVID-19 patients. Still, Aashik [ 55 ] found the qSOFA score to predict the mortality of COVID-19 patients, while Vikas [ 56 ] found the Brixia A score and qSOFA score to predict outcomes in severe forms of pregnant COVID-19 patients.…”

Section: Discussionsupporting

confidence: 91%

Brixia and qSOFA Scores, Coagulation Factors and Blood Values in Spring versus Autumn 2021 Infection in Pregnant Critical COVID-19 Patients: A Preliminary Study

et al. 2022

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(1) Background: From the recent variants of concern of the SARS-CoV-2 virus, in which the delta variant generated more negative outcomes than the alpha, we hypothesized that lung involvement, clinical condition deterioration and blood alterations were also more severe in autumn infection, when the delta variant dominated (compared with spring infections, when the alpha variant dominated), in severely infected pregnant patients. (2) Methods: In a prospective study, all pregnant patients admitted to the ICU of the Elena Doamna Obstetrics and Gynecology Hospital with a critical form of COVID-19 infection—spring group (n = 11) and autumn group (n = 7)—between 1 January 2021 and 1 December 2021 were included. Brixia scores were calculated for every patient: A score, upon admittance; H score, the highest score throughout hospitalization; and E score, at the end of hospitalization. For each day of Brixia A, H or E score, the qSOFA (quick sepsis-related organ failure assessment) score was calculated, and the blood values were also considered. (3) Results: Brixia E score, C-reactive protein, GGT and LDH were much higher, while neutrophil count was much lower in autumn compared with spring critical-form pregnant patients. (4) Conclusions: the autumn infection generated more dramatic alterations than the spring infection in pregnant patients with critical forms of COVID-19. Larger studies with more numerous participants are required to confirm these results.

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“…According to a study carried out by Alencar et al (2022) the factors associated with in-hospital death were: steroid use, cancer, male sex, and immunosuppression. The protective factors were: use of anticoagulants, rheumatological disease, and hematological disease.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Criteria in Patient Admission in the Adult Intensive Care Unit: Subsidies for the Prevention of Complications From the Nursing Perspective

Rezende¹,

Truzzi²,

Santos³

2023

JHS

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The Intensive care is based on different technological resources, however, the use of prognostic criteria supported by scientific evidence can early identify parameters related to unfavorable outcomes. Objectives: To identify the impact of the prognostic criteria used in ICU in the admission of the patient that contribute to the clinical worsening. Methodology: Exploratory, descriptive, cross-sectional study with a quantitative approach, conducted in the Intensive Care Unit of the ''Hospital Universitário'' , linked to the ''Universidade de São Paulo'' . The sample consists of patients older than 18 years hospitalized between October 2021 and January 2022, regardless of the diagnosis. Results: The prognostic criterion used in the institution is the Simplified Acute Physiology Score III. As for the sociodemographic profile, male sex predominates, mean age of 63 years and mortality rate of 26.7%; in the clinical profile, 79% had comorbidities, with hypertension and diabetes mellitus predominant. In the first 24 hours of hospitalization, 46.8% underwent mechanical ventilation, 70.6% received sedatives and 57.3% needed vasoactive drugs. As for the clinical worsening profile, the highlight parameters were: age, vital signs, Braden scales, RASS and SAPS score 3, in addition to the results of laboratory tests. The study showed that the combination of altered urea values and TTPA increase the mortality rate, with a positive predictive value of 92.3% for death. Conclusion: Health professionals must be empathetic and skilled in recognizing and managing protocols for transgender children and adolescents. Public policies must guarantee specific conduct. This topic must be included in undergraduate and graduate courses in Health and Humanities. People must be guaranteed Human Rights, regardless of sexuality.

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Performance of NEWS, qSOFA, and SIRS Scores for Assessing Mortality, Early Bacterial Infection, and Admission to ICU in COVID-19 Patients in the Emergency Department

Cited by 15 publications

References 34 publications

Comparison of prognostic scores for inpatients with COVID-19: a retrospective monocentric cohort study

Comparison of prognostic scores for inpatients with COVID-19: a retrospective monocentric cohort study

Brixia and qSOFA Scores, Coagulation Factors and Blood Values in Spring versus Autumn 2021 Infection in Pregnant Critical COVID-19 Patients: A Preliminary Study

Prognostic Criteria in Patient Admission in the Adult Intensive Care Unit: Subsidies for the Prevention of Complications From the Nursing Perspective

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