Ability of Early Warning Scores to Predict In-Hospital Mortality among Elderly Patients with COVID-19: A Medical Center Study in Taiwan

Background: During the coronavirus disease 2019 (COVID-19) pandemic, early warning scores (EWS) have been used to help emergency physicians with triage. This study aimed to evaluate the three most used EWSs: Rapid Emergency Medicine Score (REMS), Modified Early Warning Score (MEWS), and National Early Warning Score (NEWS), based on the in-hospital mortality of geriatric patients with COVID-19. Methods: This retrospective, single-center study included geriatric patients hospitalized for COVID-19 from May 2021 to July 2021 at the MacKay Memorial Hospital. Patients who (i) presented with out -of-hospital cardiac arrest (OHCA), (ii) were transferred from other hospitals, and (iii) had missing demo-graphic data were excluded. The area under the receiver operating characteristic curve (AUC) was calculated to predict the in-hospital mortality rate associated with each EWS. Results: The study included 135 patients, of whom 24 (17.8%) died. The median age of the included patients was 74.44 years, and 53% of them were men. Of the selected EWSs, MEWS (AUC = 0.761) ex-hibited the highest prognostic value, with a cutoff value of 3.5. Furthermore, NEWS (AUC = 0.758) and REMS (AUC = 0.736) exhibited good prognostic value. Conclusion: We validated the three most used EWSs, and MEWS performed well in predicting the in -hospital mortality of geriatric patients with COVID-19 using basic parameters. Copyright (c) 2024, Taiwan Society of Geriatric Emergency & Critical Care Medicine.