Abstract
ObjectiveInvestigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24h. DesignRetrospective multicenter study. SettingTwo third-level hospitals in Argentina. PatientsAll adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders. InterventionsPatients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization. VariablesWe evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48h, and at hospital admission. ResultsWe evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68–0.78) 24h before ICU admission, and 0.52 (95%CI 0.47–0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68–0.78) and 0.52 (95%CI 0.47–0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77–0.84) and 0.61 (95%CI 0.58–0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C. ConclusionCOVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization.
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