Predictive ability of the MEWS, REMS, and RAPS in geriatric patients with SARS-CoV-2 infection in the emergency department

Abstract

To compare the ability of the Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and Rapid Acute Physiology Score (RAPS) to predict 30 day-mortality in patients with SARS-CoV-2 infection aged 65 years and over. Methods: This prospective, single-center, observational study was carried out with 122 volunteers aged 65 years and over with patients confirmed to have SARS-CoV-2 infection according to the RT-PCR test, who presented to the emergency department between March 1, 2020 and May 1, 2020. Demographic data, comorbidities, vital parameters, hematological parameters, and MEWS, REMS and RAPS values of the patients were recorded prospectively. Results: Among the 122 patients included in the study, the median age was 71 (25th-75th quartile: 67-79) years. The rate of 30-day mortality was 10.7% for the study cohort. The area under the receiver operating characteristic curve values for MEWS, RAPS and REMS were 0.512 [95% confidence interval (CI): 0.420-0.604, p = 0.910], 0.500 (95% CI: 0.408-0.592, p = 0.996), and 0.675 (95% CI: 0.585-0.757, p = 0.014), respectively. The odds ratios of MEWS (≥2), RAPS (>2) and REMS (>5) for 30-day mortality were 0.374 (95% CI: 0.089-1.568, p = 0.179), 1.696 (95% CI: 0.090-31.815, p = 0.724), and 1.008 (95% CI: 0.257-3.948, p = 0.991), respectively. Conclusion: REMS, RAPS and MEWS do not seem to be useful in predicting 30-day mortality in geriatric patients with SARS-CoV-2 infection presenting to the emergency department