Observational studyEmergency medicine journal : EMJ2022
Prognostic accuracy of triage tools for adults with suspected COVID-19 in a prehospital setting: an observational cohort study.
Observational study in Emergency medicine journal : EMJ, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Timely identification of deteriorating patients from acute respiratory infections at the primary care level in the COVID-19 era: quality improvement collaborative.BMJ open quality · 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
- 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
- Low CRB-65 Scores Effectively Rule out Adverse Clinical Outcomes in COVID-19 Irrespective of Chest Radiographic Abnormalities.Biomedicines · 2023Article
- External validation of triage tools for adults with suspected COVID-19 in a middle-income setting: an observational cohort study.Emergency medicine journal : EMJ · 2023Observational
- 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
- Prehospital physiological parameters related illness severity scores can accurately discriminate the severe/critical state in adult patients with COVID-19.Annals of medicine · 2023Article
- Pre-hospital prediction of adverse outcomes in patients with suspected COVID-19: Development, application and comparison of machine learning and deep learning methods.Computers in biology and medicine · 2022Article
- Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review.Open access emergency medicine : OAEM · 2022Review
- Physiologic Scoring Systems in Predicting the COVID-19 Patients' one-month Mortality; a Prognostic Accuracy Study.Archives of academic emergency medicine · 2022Article
Corrections and comments
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Authors and funding
15 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTools proposed to triage patient acuity in COVID-19 infection have only been validated in hospital populations. We estimated the accuracy of five risk-stratification tools recommended to predict severe illness and compared accuracy to existing clinical decision making in a prehospital setting.
methodsAn observational cohort study using linked ambulance service data for patients attended by Emergency Medical Service (EMS) crews in the Yorkshire and Humber region of England between 26 March 2020 and 25 June 2020 was conducted to assess performance of the Pandemic Respiratory Infection Emergency System Triage (PRIEST) tool, National Early Warning Score (NEWS2), WHO algorithm, CRB-65 and Pandemic Medical Early Warning Score (PMEWS) in patients with suspected COVID-19 infection. The primary outcome was death or need for organ support.
resultsOf the 7549 patients in our cohort, 17.6% (95% CI 16.8% to 18.5%) experienced the primary outcome. The NEWS2 (National Early Warning Score, version 2), PMEWS, PRIEST tool and WHO algorithm identified patients at risk of adverse outcomes with a high sensitivity (>0.95) and specificity ranging from 0.3 (NEWS2) to 0.41 (PRIEST tool). The high sensitivity of NEWS2 and PMEWS was achieved by using lower thresholds than previously recommended. On index assessment, 65% of patients were transported to hospital and EMS decision to transfer patients achieved a sensitivity of 0.84 (95% CI 0.83 to 0.85) and specificity of 0.39 (95% CI 0.39 to 0.40).
conclusionUse of NEWS2, PMEWS, PRIEST tool and WHO algorithm could improve sensitivity of EMS triage of patients with suspected COVID-19 infection. Use of the PRIEST tool would improve sensitivity of triage without increasing the number of patients conveyed to hospital.
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