MEWS、REMS 和 RAPS 在急诊科感染 SARS-CoV-2 的老年患者中的预测能力。

Predictive Ability of the MEWS, REMS, and RAPS in Geriatric Patients With SARS-CoV-2 Infection in the Emergency Department.

机构信息

Department of Emergency Medicine, University of Health Sciences Ümraniye Training and Research Hospital, Istanbul, Turkey.

Department of Emergency Medicine, Karamanoğlu Mehmet Bey University, Istanbul, Turkey.

出版信息

Disaster Med Public Health Prep. 2022 May 2;17:e174. doi: 10.1017/dmp.2022.107.

DOI:10.1017/dmp.2022.107

PMID:35492014

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9253434/

Abstract

BACKGROUND

The aim of this study was to compare the ability of the Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and Rapid Acute Physiology Score (RAPS) to predict 30-d mortality in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection aged 65 y and over.

METHODS

This prospective, single-center, observational study was carried out with 122 volunteers aged 65 y and over with patients confirmed to have SARS-CoV-2 infection according to the reverse transcriptase-polymerase chain reaction (RT-PCR) test, who presented to the emergency department between March 1, 2020, and May 1, 2020. Demographic data, comorbidities, vital parameters, hematological parameters, and MEWS, REMS, and RAPS values of the patients were recorded prospectively.

RESULTS

Among the 122 patients included in the study, the median age was 71 (25th-75th quartile: 67-79) y. The rate of 30-d mortality was 10.7% for the study cohort. The area under the receiver operating characteristic curve values for MEWS, RAPS, and REMS were 0.512 (95% confidence interval [CI]: 0.420-0.604; = 0.910), 0.500 (95% CI: 0.408-0.592; = 0.996), and 0.675 (95% CI: 0.585-0.757; = 0.014), respectively. The odds ratios of MEWS (≥2), RAPS (>2), and REMS (>5) for 30-d mortality were 0.374 (95% CI: 0.089-1.568; = 0.179), 1.696 (95% CI: 0.090-31.815; = 0.724), and 1.008 (95% CI: 0.257-3.948; = 0.991), respectively.

CONCLUSIONS

REMS, RAPS, and MEWS do not seem to be useful in predicting 30-d mortality in geriatric patients with SARS-CoV-2 infection presenting to the emergency department.

摘要

背景

本研究旨在比较改良早期预警评分（MEWS）、快速急诊医学评分（REMS）和快速急性生理学评分（RAPS）预测年龄≥ 65 岁因严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染而住院的患者 30 天死亡率的能力。

方法

这是一项前瞻性、单中心、观察性研究，共纳入 122 名年龄≥ 65 岁的志愿者，他们均根据逆转录酶聚合酶链反应（RT-PCR）检测确诊为 SARS-CoV-2 感染，于 2020 年 3 月 1 日至 5 月 1 日期间因 SARS-CoV-2 感染到急诊科就诊。前瞻性记录患者的人口统计学数据、合并症、生命体征、血液学参数以及 MEWS、REMS 和 RAPS 值。

结果

本研究共纳入 122 例患者，中位年龄为 71 岁（25 分位至 75 分位：67-79 岁）。研究队列的 30 天死亡率为 10.7%。MEWS、RAPS 和 REMS 的受试者工作特征曲线下面积分别为 0.512（95%置信区间：0.420-0.604；P = 0.910）、0.500（95%置信区间：0.408-0.592；P = 0.996）和 0.675（95%置信区间：0.585-0.757；P = 0.014）。MEWS（≥2 分）、RAPS（>2 分）和 REMS（>5 分）的 30 天死亡率比值比分别为 0.374（95%置信区间：0.089-1.568；P = 0.179）、1.696（95%置信区间：0.090-31.815；P = 0.724）和 1.008（95%置信区间：0.257-3.948；P = 0.991）。