Role of the National Early Warning score and Modified Early Warning score for predicting mortality in geriatric patients with non-traumatic coma.

ABSTRACT

Geriatric patients arriving in a non-traumatic coma (NTC) at the emergency department (ED) present substantial risks and necessitate prompt and appropriate care. The National Early Warning Score (NEWS) is a promising tool that can efficiently evaluate this vulnerable population. Current study was designed to assess the effectiveness of the NEWS for predicting the severity of illness in geriatric patients with NTC and identifying those at highest risk. Current study was performed involving geriatric patients (aged ≥65 years) with NTC who visited Chonnam National University Hospital between January and December 2022. NEWS and Modified Early Warning Scores (MEWS) were calculated at ED visits. The association of NEWS and MEWS for in-hospital death was evaluated by multivariable analysis. Out of 683 patients, 202 were non-survivors (29.6%). The NEWS and MEWS values of non-survivors were higher than those of survivors (NEWS, 7 [5-10] vs. 10 [8-12]; MEWS, 5 [4-6] vs. 7 [5-8]). The NEWS (adjusted odds ratio [aOR]; 1.253, 95% confidence interval [CI] 1.181-1.329) and MEWS (aOR; 1.323, 95% CI 1.206-1.451) were also significantly associated with in-hospital death. The area under the curve for the NEWS and MEWS was 0.721 (95% CI 0.685-0.754) and 0.695 (95% CI 0.659-0.730), respectively. The NEWS can be an effective tool for predicting severity of illness via in-hospital death in geriatric patients with NTC.