Observational studyEmergency medicine journal : EMJ2021
Prognostic accuracy of emergency department triage tools for adults with suspected COVID-19: the PRIEST observational cohort study.
Observational study in Emergency medicine journal : EMJ, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 46 citations in OpenAlex.
- Development of remote radar based vital sign acquisition for emergency department patient triage.Frontiers in medical technology · 2026Article
- Optimizing pediatric emergency triage in low-resource settings: evidence-based strategies, task-shifting, and technological innovations.International journal of emergency medicine · 2025Review
- Clinical presentation of Enterovirus D68 in adults with acute respiratory infections consulting in emergency departments in Quebec, Canada.IJID regions · 2025Article
- Accuracy of the National Early Warning Score version 2 (NEWS2) in predicting need for time-critical treatment: retrospective observational cohort study.Emergency medicine journal : EMJ · 2025Observational
- COVID-19: association of the National Early Warning Score with triage categories, severity and outcomes.Revista brasileira de enfermagem · 2025Article
- Assessment of the performance of early warning scores in patients with COVID-19.Revista da Escola de Enfermagem da U S P · 2025Article
- Comparison of the ALKA and CRS scores to predict outcomes among patients with coronavirus disease 2019 infection in United Arab Emirates.Frontiers in medicine · 2025Article
- Prehospital Pandemic Respiratory Infection Emergency System Triage score can effectively predict the 30-day mortality of COVID-19 patients with pneumonia.Annals of medicine · 2024Article
- Performance of the 4C and SEIMC scoring systems in predicting mortality from onset to current COVID-19 pandemic in emergency departments.Scientific reports · 2024Observational
- Scoring systems for prediction of malaria and dengue fever in non-endemic areas among travellers arriving from tropical and subtropical areas.Emergency medicine journal : EMJ · 2024Article
- Prognostic accuracy of eight triage scores in suspected COVID-19 in an Emergency Department low-income setting: An observational cohort study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Head-to-head comparison of six warning scores to predict mortality and clinical impairment in COVID-19 patients in emergency department.Internal and emergency medicine · 2023Observational
- Low CRB-65 Scores Effectively Rule out Adverse Clinical Outcomes in COVID-19 Irrespective of Chest Radiographic Abnormalities.Biomedicines · 2023Article
- Validation of the qSOFA and CRB-65 in SARS-CoV-2-infected community-acquired pneumonia.ERJ open research · 2023Article
- The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis.Annals of translational medicine · 2023Article
- Article
- LMIC-PRIEST: Derivation and validation of a clinical severity score for acutely ill adults with suspected COVID-19 in a middle-income setting.medRxiv : the preprint server for health sciences · 2022Article
- Evaluation of the utility of NEWS2 during the COVID-19 pandemic.Clinical medicine (London, England) · 2022Review
- Comparing complaint-based triage scales and early warning scores for emergency department triage.Emergency medicine journal : EMJ · 2022Article
- Observational
Corrections and comments
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Authors and funding
23 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe WHO and National Institute for Health and Care Excellence recommend various triage tools to assist decision-making for patients with suspected COVID-19. We aimed to compare the accuracy of triage tools for predicting severe illness in adults presenting to the ED with suspected COVID-19.
methodsWe undertook a mixed prospective and retrospective observational cohort study in 70 EDs across the UK. We collected data from people attending with suspected COVID-19 and used presenting data to determine the results of assessment with the WHO algorithm, National Early Warning Score version 2 (NEWS2), CURB-65, CRB-65, Pandemic Modified Early Warning Score (PMEWS) and the swine flu adult hospital pathway (SFAHP). We used 30-day outcome data (death or receipt of respiratory, cardiovascular or renal support) to determine prognostic accuracy for adverse outcome.
resultsWe analysed data from 20 891 adults, of whom 4611 (22.1%) died or received organ support (primary outcome), with 2058 (9.9%) receiving organ support and 2553 (12.2%) dying without organ support (secondary outcomes). C-statistics for the primary outcome were: CURB-65 0.75; CRB-65 0.70; PMEWS 0.77; NEWS2 (score) 0.77; NEWS2 (rule) 0.69; SFAHP (6-point rule) 0.70; SFAHP (7-point rule) 0.68; WHO algorithm 0.61. All triage tools showed worse prediction for receipt of organ support and better prediction for death without organ support. At the recommended threshold, PMEWS and the WHO criteria showed good sensitivity (0.97 and 0.95, respectively) at the expense of specificity (0.30 and 0.27, respectively). The NEWS2 score showed similar sensitivity (0.96) and specificity (0.28) when a lower threshold than recommended was used.
conclusionCURB-65, PMEWS and the NEWS2 score provide good but not excellent prediction for adverse outcome in suspected COVID-19, and predicted death without organ support better than receipt of organ support. PMEWS, the WHO criteria and NEWS2 (using a lower threshold than usually recommended) provide good sensitivity at the expense of specificity. TRIAL REGISTRATION NUMBER: ISRCTN56149622.
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