ArticleEClinicalMedicine2021
The ROX index has greater predictive validity than NEWS2 for deterioration in Covid-19.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Prognostic models in COVID-19 infection that predict severity: a systematic review.European journal of epidemiology · 2023Pooled it
- The Prognostic Accuracy of National Early Warning Score 2 on Predicting Clinical Deterioration for Patients With COVID-19: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Racial Differences in Accuracy of Predictive Models for High-Flow Nasal Cannula Failure in COVID-19.Critical care explorations · 2024Article
- The National Early Warning Score 2 with Age and Body Mass Index (NEWS2 Plus) to Determine Patients with Severe COVID-19 Pneumonia.Journal of clinical medicine · 2024Article
- Predictive value of the National Early Warning Score 2 for hospitalised patients with viral respiratory illness is improved by the addition of inspired oxygen fraction as a weighted variable.BMJ open respiratory research · 2023Article
- SUPER Score Contributes to Warning and Management in Early-Stage COVID-19.Infectious medicine · 2023Article
- Article
- [ROX index to predict failure with low flow devices in COVID-19].Revista medica del Instituto Mexicano del Seguro Social · 2023Observational
- Delineating COVID-19 subgroups using routine clinical data identifies distinct in-hospital outcomes.Scientific reports · 2023Article
- The United Kingdom's National Early Warning Score: should everyone use it? A narrative review.Internal and emergency medicine · 2023Review
- Prognostication of COVID-19 patients using ROX index and CURB-65 score - A retrospective observational study.Journal of family medicine and primary care · 2022Article
- Leukocyte glucose index as a novel biomarker for COVID-19 severity.Scientific reports · 2022Article
- Comparison of prognostic scores for inpatients with COVID-19: a retrospective monocentric cohort study.BMJ open respiratory research · 2022Article
- Silent hypoxia is not an identifiable characteristic in patients with COVID-19 infection.Respiratory medicine · 2022Observational
- Using admission SpO2 and ROX index predict outcome in patients with COVID-19.The American journal of emergency medicine · 2022Article
- ERS International Congress 2021: highlights from the Respiratory Intensive Care Assembly.ERJ open research · 2022Article
- Thoracic Society of Australia and New Zealand Position Statement on Acute Oxygen Use in Adults: 'Swimming between the flags'.Respirology (Carlton, Vic.) · 2022Article
- Exploring the impact of pulse oximeter selection within the COVID-19 home-use pulse oximetry pathways.BMJ open respiratory research · 2022Article
- The Development and Validation of Simplified Machine Learning Algorithms to Predict Prognosis of Hospitalized Patients With COVID-19: Multicenter, Retrospective Study.Journal of medical Internet research · 2022Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients admitted to hospital with Covid-19 are at risk of deterioration. The National Early Warning Score (NEWS2) is widely recommended, however it's validity in Covid-19 is not established and indices more specific for respiratory failure may be more appropriate. We aim to describe the physiological antecedents to deterioration, test the predictive validity of NEWS2 and compare this to the ROX index ([SpO
methodA single centre retrospective cohort study of adult patients who were admitted to a medical ward, between 1/3/20 and 30/5/20, with positive results for SARS-CoV-2 RNA. Physiological observations and the NEWS2 were extracted and analysed. The primary outcome was a composite of cardiac arrest, unplanned critical care admission or death within 24 hours. A generalized linear model was used to assess the association of physiological values, NEWS2 and ROX with the outcome.
findingsThe primary outcome occurred in 186 patients (26%). In the preceding 24 hours, deterioration was most marked in respiratory parameters, specifically in escalating oxygen requirement; tachypnoea was a late sign, whilst cardiovascular observations remained stable. The area under the receiver operating curve was 0.815 (95% CI 0.804-0.826) for NEWS2 and 0.848 (95% CI 0.837-0.858) for ROX. Applying the optimal level of ROX, the majority of patients triggered four hours earlier than with NEWS2 of 5.
interpretationNEWS2 may under-perform in Covid-19 due to intrinsic limitations of the design and the unique pathophysiology of the disease. A simple index utilising respiratory parameters can outperform NEWS2 in predicting the occurrence of adverse events.
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