ArticleTurkish journal of medical sciences2023
Evaluation of prognostic scoring systems in patients hospitalized from the emergency department in a low-income region: northern Syria after internal turmoil as a different universe.
Article in Turkish journal of medical sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Accuracy of prognostic scoring tools for ICU triage and mortality among patients in low- and middle-income countries: a systematic review and meta-analysis.BMJ open respiratory research · 2026Pooled it
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Abstract
backgroundIn low-income or underdeveloped countries with conflict and internal unrest, healthcare facilities and staff are limited. For these reasons, it is necessary to use the most straightforward scoring systems to ensure that health facilities and staff are used effectively and to expedite processes through early and effective interventions for patients. In this study, we evaluate and compare the scoring systems used to predict patient prognosis for Emergency Department (ED) patients in northern Syria, which is an area marred by conflict and internal unrest.
methodsIn this study, patients hospitalized in the Afrin, Azez Vatan, Jarablus, Tel Abyad, Rasulayn, El Bab, and Çobanbey hospitals in northern Syria were investigated. Only patients that were hospitalized in the emergency departments of these hospitals, including wards and intensive care units, were included in the study. Patients that were hospitalized from 03/01/2021 to 08/31/2021, the study period, were prospectively analyzed. Vital signs, medical histories and demographic data of the patients were recorded by calculating National Early Warning Score 2 (NEWS2), Rapid Acute Physiology Score (RAPS), Rapid Emergency Medicine Score (REMS), and HOTEL Score (hypotension, oxygen saturation, low temperature, electrocardiogram, loss of independence). Acceptance parameters and scores were analyzed using statistical methods and by comparing groups.
results: All four scoring systems were found to be effective in predicting mortality regarding ROC curve analysis. However, the statistical significance of the RAPS was slightly stronger than that of the other scores and REMS had the highest sensitivity and specificity amongst the four systems, at 86.2% and 84.1%, respectively. Regarding the risk of hospitalization in the ICU (p < 0.05), the sensitivity values of the cut-off values offered by the scoring systems remained below 0.70 regarding ROC curve analysis. RAPS had the highest sensitivity (65.2%) of the four systems with a cut-off value of 1.5. DISCUSSION: This study in northern Syria has shown that although RAPS had stronger statistical power, REMS had better sensitivity and specificity for the prediction of mortality. Additionally, RAPS had better sensitivity for ICU risk. This study will contribute to the evaluation of healthcare in similar regions and to cost-effective healthcare delivery by using scoring systems for ED patients' admission.
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