Table 2.
Sensitivity, specificity, negative and positive predictive value, and positive and negative likelihood ratio of the hospital triage score and of the EWS for predicting ICU admission within 48 hours and 7 days from ED admission. Optimal cut off values for sensitivity and specificity were chosen according to Youden index. Values of the EWS with the largest AUROC are in bold.
| AUROC | cut-off | Sensitivity (%) | Specificity (%) | +LR | -LR | PPV | NPV | |
|---|---|---|---|---|---|---|---|---|
| Admission to ICU within 48 hours | ||||||||
| TRIAGE | 0.839 [0.795 – 0.877] | ≤ 2 | 66.0 [51.2 – 78.8] | 89.8 [85.7 – 93.1] | 6.5 [4.3 – 9.6] | 0.4 [0.3 – 0.6] | 53.2 [43.3 – 62.9] | 93.7 [91.1 – 95.7] |
| MEWS | 0.652 [0.598 – 0.703] | > 5 | 70.0 [55.4 – 82.1] | 64.8 [58.9 – 70.3] | 2.0 [1.6 – 2.5] | 0.5 [0.3 – 0.7] | 25.9 [21.6 – 30.8] | 92.5 [88.8 – 95.0] |
| NEWS | 0.802 [0.756 – 0.844] | > 5 | 66.0 [51.2 – 78.8] | 84.9 [80.2 – 88.8] | 4.4 [3.1 – 6.1] | 0.4 [0.3 – 0.6] | 43.4 [35.3 – 51.9] | 93.4 [90.6 – 95.4] |
| NEWS2 | 0.780 [0.731 – 0.823] | > 4 | 70.0 [55.4 – 82.1] | 78.5 [73.3 – 83.2] | 3.3 [2.4 – 4.3] | 0.4 [0.2 – 0.6] | 36.5 [30.1 – 43.3] | 93.7 [90.6 – 95.8] |
| NEWS-C | 0.771 [0.701 – 0.831] | > 8 | 62.9 [44.9 – 78.5] | 82.7 [75.4 – 88.6] | 3.6 [2.3 – 5.7] | 0.5 [0.3 – 0.7] | 47.8 [37.0 – 58.8] | 89.8 [85.1 – 93.2] |
| qSOFA | 0.566 [0.511 – 0.620] | > 0 | 34.0 [21.2 – 48.8] | 79.6 [74.4 – 84.1] | 1.7 [1.1 – 2.6] | 0.8 [0.7 – 1.0] | 22.7 [15.8 – 31.5] | 87.3 [84.8 – 89.4] |
| REMS | 0.742 [0.692 – 0.788] | > 6 | 60.0 [45.2 – 73.6] | 75.0 [69.5 – 79.9] | 2.4 [1.8 – 3.2] | 0.5 [0.4 – 0.8] | 29.7 [23.8 – 36.4] | 91.4 [88.3 – 93.8] |
| Admission to ICU within 7 days | ||||||||
| TRIAGE | 0.818 [0.773 – 0.858] | ≤ 2 | 58.9 [45.0 – 71.9] | 89.6 [85.4 – 92.9] | 5.6 [3.8 – 8.5] | 0.5 [0.3 – 0.6] | 53.2 [43.1 – 63.1] | 91.5 [88.8 – 93.7] |
| MEWS | 0.618 [0.564 – 0.671] | > 5 | 66.1 [52.2 – 78.2] | 64.8 [58.8 – 70.4] | 1.9 [1.5 – 2.4] | 0.5 [0.4 – 0.8] | 27.4 [22.8 – 32.6] | 90.5 [86.7 – 93.2] |
| NEWS | 0.783 [0.735 – 0.826] | > 4 | 71.4 [57.8 – 82.7] | 77.3 [72.1 – 82.1] | 3.2 [2.4 – 4.1] | 0.4 [0.2 – 0.6] | 38.8 [32.6 – 45.5] | 93.1 [89.8 – 95.3] |
| NEWS2 | 0.762 [0.714 – 0.807] | > 4 | 67.8 [54.0 – 79.7] | 79.1 [73.9 – 83.8] | 3.2 [2.4 – 4.4] | 0.4 [0.3 – 0.6] | 39.6 [32.9 – 46.7] | 92.4 [89.3 – 94.7] |
| NEWS-C | 0.755 [0.684 – 0.817] | > 8 | 60.1 [51.9 – 81.9] | 84.2 [76.9 – 90.0] | 3.9 [2.4 – 6.1] | 0.5 [0.3 – 0.7] | 54.3 [42.8 – 65.4] | 87.5 [82.6 – 91.2] |
| qSOFA | 0.557 [0.501 – 0.611] | > 0 | 32.1 [20.3 – 46.0] | 79.5 [74.3 – 84.1] | 1.6 [1.0 – 2.4] | 0.8 [0.7 – 1.0] | 24.0 [16.8 – 33.0] | 85.3 [82.8 – 87.5] |
| REMS | 0.735 [0.685 – 0.782] | > 6 | 58.9 [45.0 – 71.9] | 75.5 [70.0 – 80.5] | 2.4 [1.8 – 3.3] | 0.5 [0.4 – 0.7] | 32.7 [26.4 – 39.6] | 90.1 [86.9 – 92.6] |
Abbreviations: TRIAGE (Triage code assigned in ED); MEWS Modified Early Warning Score; NEWS National Early Warning Score; NEWS-C: modi0fied NEWS; qSOFA quick Sequential Organ Failure Assessment; REMS Rapid Emergency Medicine Score; +LR Positive Likelihood Ratio; −LR Negative Likelihood Ratio; PPV Positive Predictive Value; NPV Negative Predictive Value.