Bartolomeu Victoria Castilho, Piacezzi Luiz Humberto Vieri, Costa Karina Aparecida Lopes da, Batista Ruth Ester Assayag, Campanharo Cássia Regina Vancini, Lopes Maria Carolina Barbosa Teixeira
Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil.
Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem Clínica e Cirúrgica, São Paulo, SP, Brazil.
Rev Esc Enferm USP. 2025 May 26;59:e20240371. doi: 10.1590/1980-220X-REEUSP-2024-0371en. eCollection 2025.
To assess the performance of the early warning scores Modified Early Warning Score, National Early Warning Score 2, National Early Warning Score Age and quick Sepsis Related Organ Failure Assessment for identifying clinical deteriorations in patients with COVID-19.
A retrospective cohort study. Patients with confirmed diagnosis of COVID-19 were included. Clinical deteriorations were acute respiratory failure, shock and cardiorespiratory arrest, and the outcomes were unscheduled admission to the Intensive Care Unit, discharge and death. The sensitivity and probability of a positive result in patients (true positive) and the specificity and probability of a negative result in non-patients (true negative) were determined.
The National Early Warning Score 2 and the National Early Warning Score Age showed better sensitivity values for early identification of deteriorations and outcomes.
NEWS 2 and NEWS A showed better sensitivity and specificity, and their use is recommended to support the clinical assessment of patients with COVID-19. This study contributes to healthcare practice by assessing scores that can improve clinical assessment, allowing rapid identification of signs of deterioration in patients affected by COVID-19 and early interventions.
评估改良早期预警评分、国家早期预警评分2、国家早期预警评分年龄和快速脓毒症相关器官功能衰竭评估等早期预警评分在识别新型冠状病毒肺炎(COVID-19)患者临床病情恶化方面的表现。
一项回顾性队列研究。纳入确诊为COVID-19的患者。临床病情恶化定义为急性呼吸衰竭、休克和心肺骤停,结局为入住重症监护病房、出院和死亡。确定患者中阳性结果的敏感性和概率(真阳性)以及非患者中阴性结果的特异性和概率(真阴性)。
国家早期预警评分2和国家早期预警评分年龄在早期识别病情恶化和结局方面显示出更好的敏感性值。
国家早期预警评分2(NEWS 2)和国家早期预警评分年龄(NEWS A)显示出更好的敏感性和特异性,建议使用它们来辅助对COVID-19患者的临床评估。本研究通过评估可改善临床评估的评分,有助于医疗实践,从而能够快速识别受COVID-19影响患者的病情恶化迹象并进行早期干预。