DİLAY SATILMIŞ, EGEMEN YILDIZ, ERDEM ÇEVİK
Comprehensive Medicine - 2023;15(1):20-26
INTRODUCTION: Pandemics and epidemics have significantly affected public health over the years and have shown us the importance of evaluating the prognosis at the early stage. In the coronavirus disease-19 (COVID-19) pandemic, the necessity of clinical scoring in the triage of patients with similar clinical characteristics in the primary care was highlighted. This study aims to investigate the effectiveness of the Pandemic Medical Early Warning Score (PMEWS), which is a clinical score, in the primary care triage of patients and in distinguishing the risk of 30-day mortality in the COVID-19 pandemic. METHODS: Data from confirmed COVID-19 patients in the emergency department (ED) were analyzed retrospectively between March 2020, and July 2020. The area under the curve (AUC) was used to evaluate the discriminatory power of the PMEWS in predicting all-cause 30-day mortality. Results: Four hundred and fifty-eight patients were included in this study. The median age of the patients was 54.5 years (IQR 32.25 years). There was at least one coexisting disease in 227 (49.6%) of the patients, and it was significantly higher in non-survivor patients compared to survivors (p<0.05). ROC analysis of the PMEWS showed the optimal cutoffs for the 30-day mortality to be 4 (sensitivity 93.33, specificity 82.62). The AUC of the PMEWS for predicting all-cause 30-day mortality was 0.931. DISCUSSION AND CONCLUSION: PMEWS is a non-disease-specific and physiological-social score at times of high ED admissions in a pandemic and can be a potentially useful triage tool for pre-examination patient triage and for estimating mortality during pandemic periods. More detailed studies are needed to determine the effectiveness of scorings in pandemics.
