Table 2.
Performance of early warning scores in predicting clinical deterioration.
| Outcomes | Predictors | AUROC | 95% CI | P | Cut-off | Sensitivity (%) | Specificity (%) | PPV | NPV | LR+ | LR– |
|---|---|---|---|---|---|---|---|---|---|---|---|
| EDRF | NEWS | 0.73 ± 0.06 | 0.62–0.84 | <0.001 | 5 | 81.5 | 42.7 | 30.1 | 88.4 | 1.42 | 0.43 |
| 6 | 70.4 | 65.2 | 38 | 87.9 | 2.02 | 0.45 | |||||
| 7 | 55.6 | 78.7 | 44.1 | 85.4 | 2.6 | 0.57 | |||||
| NEWS-C | 0.79 ± 0.05 | 0.69–0.89 | <0.001 | 8 | 66.7 | 73.0 | 42.9 | 87.8 | 2.47 | 0.46 | |
| 9 | 59.3 | 85.4 | 55.2 | 87.4 | 4.06 | 0.48 | |||||
| 10 | 51.9 | 91.0 | 63.6 | 86.2 | 5.77 | 0.53 | |||||
| NEWS2 | 0.59 ± 0.07 | 0.46–0.72 | 0.18 | 5 | 74.1 | 23.6 | 22.7 | 75 | 0.97 | 1.1 | |
| 6 | 74.1 | 41.6 | 27.8 | 84.1 | 1.27 | 0.62 | |||||
| 7 | 55.6 | 56.2 | 27.8 | 80.6 | 1.27 | 0.79 | |||||
| HEWS | 0.75 ± 0.06 | 0.63–0.86 | <0.001 | 5 | 59.3 | 79.8 | 47.1 | 86.6 | 2.93 | 0.51 | |
| 6 | 51.9 | 89.9 | 60.9 | 86.0 | 5.13 | 0.54 | |||||
| 7 | 33.3 | 92.1 | 56.2 | 82 | 4.24 | 0.72 | |||||
| MEWS | 0.71 ± 0.06 | 0.59–0.83 | <0.001 | 2 | 85.2 | 27.0 | 26.1 | 85.7 | 1.17 | 0.55 | |
| 3 | 74.1 | 68.5 | 41.7 | 89.7 | 2.35 | 0.38 | |||||
| 4 | 37.0 | 83.2 | 40 | 81.3 | 2.2 | 0.76 | |||||
| qSOFA | 0.62 ± 0.06 | 0.51–0.74 | 0.04 | 1 | 70.4 | 44.9 | 27.9 | 83.3 | 1.28 | 0.66 | |
| 2 | 18.5 | 97.8 | 71.4 | 79.8 | 8.24 | 0.83 | |||||
| Need for IRS | NEWS | 0.86 ± 0.04 | 0.78–0.95 | <0.001 | 6 | 87.5 | 68.5 | 42 | 95.5 | 2.78 | 0.18 |
| 7 | 75 | 82.6 | 52.9 | 92.7 | 4.31 | 0.3 | |||||
| 8 | 54.2 | 90.2 | 59.1 | 88.3 | 5.54 | 0.51 | |||||
| NEWS-C | 0.89 ± 0.03 | 0.82–0.96 | <0.001 | 8 | 79.2 | 75 | 45.2 | 93.2 | 3.17 | 0.28 | |
| 9 | 75 | 88 | 62.1 | 93.1 | 6.27 | 0.28 | |||||
| 10 | 66.7 | 93.5 | 72.7 | 91.5 | 10.22 | 0.36 | |||||
| NEWS2 | 0.69 ± 0.06 | 0.57–0.81 | 0.002 | 8 | 45.8 | 69.6 | 28.2 | 83.1 | 1.51 | 0.78 | |
| 9 | 41.7 | 88.0 | 47.6 | 85.3 | 3.48 | 0.66 | |||||
| 10 | 20.8 | 96.7 | 62.5 | 82.4 | 6.39 | 0.82 | |||||
| HEWS | 0.87 ± 0.05 | 0.77–0.97 | <0.001 | 5 | 79.2 | 83.7 | 55.9 | 93.9 | 4.86 | 0.25 | |
| 6 | 70.8 | 93.5 | 73.9 | 92.5 | 10.86 | 0.31 | |||||
| 7 | 50 | 95.7 | 75 | 88 | 11.5 | 0.52 | |||||
| MEWS | 0.80 ± 0.05 | 0.70–0.90 | <0.001 | 2 | 91.7 | 28.3 | 25 | 92.9 | 1.28 | 0.29 | |
| 3 | 87.5 | 70.7 | 43.7 | 95.6 | 2.98 | 0.18 | |||||
| 4 | 50 | 85.9 | 48 | 86.8 | 3.54 | 0.58 | |||||
| qSOFA | 0.72 ± 0.05 | 0.61–0.82 | <0.001 | 1 | 83.3 | 47.8 | 29.4 | 91.7 | 1.6 | 0.35 | |
| 2 | 25 | 98.9 | 85.7 | 83.5 | 23 | 0.76 |
AUROC, area under the receiver operating characteristic curve; CI, confidence interval; LR, likelihood ratio; PPV, positive predictive value; NPV, negative predictive value; HEWS, Hamilton Early Warning Score; MEWS, Modified Early Warning Score; NEWS, National Early Warning Score; NEWS-C, modified NEWS; NEWS 2, National Early Warning Score 2; qSOFA, quick Sepsis-related Organ Failure Assessment; EDRF, early deterioration of respiratory function; IRS, intensive respiratory support. Bold: the optimal cut-off values according to Youden index.