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Medizinische Klinik - Intensivmedizin und Notfallmedizin

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04.07.2023 | Originalien

Prognostic value of early warning scores in patients presenting to the emergency department with exacerbation of COPD

verfasst von: Prof. Dr. Nurettin Özgür Doğan, M.D., Ass. Prof. İbrahim Ulaş Özturan, Prof. Dr. Murat Pekdemir, Prof. Dr. Elif Yaka, Prof. Dr. Serkan Yılmaz

Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin | Ausgabe 2/2024

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Abstract

Objective

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a condition that frequently presents to the emergency department (ED) and its prognosis is not very well understood. Risk tools that can be used rapidly in the ED are needed to predict the prognosis of these patients.

Methods

This study comprised a retrospective cohort of AECOPD patients presenting to a single center between 2015 and 2022. The prognostic accuracy of several clinical early warning scoring systems, Modified Early Warning Score (MEWS), National Early Warning Score (NEWS), NEWS‑2, Systemic Inflammatory Response Syndrome (SIRS) and the quick Sepsis-related Organ Failure Assessment (qSOFA), were compared. The outcome variable was determined as one-month mortality.

Results

Of the 598 patients, 63 (10.5%) had died within 1 month after presenting to the ED. Patients who died had more often congestive heart failure, altered mental status, and admission to intensive care, and they were older. Although the MEWS, NEWS, NEWS‑2, and qSOFA scores of those who died were higher than those who survived, there was no difference between the SIRS scores of these two groups. The score with the highest positive likelihood ratio for mortality estimation was qSOFA (8.5, 95% confidence interval [CI] 3.7–19.6). The negative likelihood ratios of the scores were similar, the NEWS score had a negative likelihood ratio of 0.4 (95% CI 0.2–0.8) with the highest negative predictive value of 96.0%.

Conclusion

In AECOPD patients, most of the early warning scores that are frequently used in the ED were found to have a moderate ability to exclude mortality and a low ability to predict mortality.

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Titel: Prognostic value of early warning scores in patients presenting to the emergency department with exacerbation of COPD
verfasst von: Prof. Dr. Nurettin Özgür Doğan, M.D.
Ass. Prof. İbrahim Ulaş Özturan
Prof. Dr. Murat Pekdemir
Prof. Dr. Elif Yaka
Prof. Dr. Serkan Yılmaz
Publikationsdatum: 04.07.2023
Verlag: Springer Medizin
Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin / Ausgabe 2/2024
Print ISSN: 2193-6218
Elektronische ISSN: 2193-6226
DOI: https://doi.org/10.1007/s00063-023-01036-5

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Prognostic value of early warning scores in patients presenting to the emergency department with exacerbation of COPD