ArticleBMC emergency medicine2023
The utility of the Rapid Emergency Medicine Score (REMS) compared with three other early warning scores in predicting in-hospital mortality among COVID-19 patients in the emergency department: a multicenter validation study.
Article in BMC emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 13 citations in OpenAlex.
- Machine learning for risk stratification in the emergency department (MARS-ED): a randomized controlled trial.Nature communications · 2025Trial
- Evaluating the predictive performance of PIRO score against six clinical prediction scores for COVID-19 outcomes in the emergency department.Scientific reports · 2025Article
- Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction.Scientific reports · 2025Article
- Performance of A-DROP, NEWS2, and REMS in predicting in-hospital mortality and mechanical ventilation in pneumonia patients in the emergency department: a retrospective cohort study.International journal of emergency medicine · 2024Article
- Reevaluation of prognostic and severity indicators for COVID-19 patients in the emergency department.Annals of medicine · 2024Article
- Unveiling the performance of the prehospital Rapid Emergency Medicine Score (pREMS): How the predictive score impacts in-hospital outcomes in traumatic brain injury (TBI): A retrospective observational cohort study.BMC emergency medicine · 2024Observational
- Presepsin as a prognostic biomarker in COVID-19 patients: combining clinical scoring systems and laboratory inflammatory markers for outcome prediction.Virology journal · 2024Article
- Predicting Mortality for COVID-19 Patients Admitted to an Emergency Department Using Early Warning Scores in Poland.Healthcare (Basel, Switzerland) · 2024Article
- ANCOC Score to Predict Mortality in Different SARS-CoV-2 Variants and Vaccination Status.Journal of clinical medicine · 2023Article
- The Predictive Value of Risk Factors and Prognostic Scores in Hospitalized COVID-19 Patients.Diagnostics (Basel, Switzerland) · 2023Article
- Early Warning Scores for COVID-19 Outcomes: Modified Early Warning Score and Rapid Emergency Medicine Score Performance in Mortality and Hospital Readmission Risk Stratification.Iranian journal of nursing and midwifery researchArticle
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany early warning scores (EWSs) have been validated to prognosticate adverse outcomes of COVID-19 in the Emergency Department (ED), including the quick Sequential Organ Failure Assessment (qSOFA), the Modified Early Warning Score (MEWS), and the National Early Warning Score (NEWS). However, the Rapid Emergency Medicine Score (REMS) has not been widely validated for this purpose. We aimed to assess and compare the prognostic utility of REMS with that of qSOFA, MEWS, and NEWS for predicting mortality in emergency COVID-19 patients.
methodsWe conducted a multi-center retrospective study at five EDs of various levels of care in Thailand. Adult patients visiting the ED who tested positive for COVID-19 prior to ED arrival or within the index hospital visit between January and December 2021 were included. Their EWSs at ED arrival were calculated and analysed. The primary outcome was all-cause in-hospital mortality. The secondary outcome was mechanical ventilation.
resultsA total of 978 patients were included in the study; 254 (26%) died at hospital discharge, and 155 (15.8%) were intubated. REMS yielded the highest discrimination capacity for in-hospital mortality (the area under the receiver operator characteristics curves (AUROC) 0.771 (95% confidence interval (CI) 0.738, 0.804)), which was significantly higher than qSOFA (AUROC 0.620 (95%CI 0.589, 0.651); p < 0.001), MEWS (AUROC 0.657 (95%CI 0.619, 0.694); p < 0.001), and NEWS (AUROC 0.732 (95%CI 0.697, 0.767); p = 0.037). REMS was also the best EWS in terms of calibration, overall model performance, and balanced diagnostic accuracy indices at its optimal cutoff. REMS also performed better than other EWSs for mechanical ventilation.
conclusionREMS was the early warning score with the highest prognostic utility as it outperformed qSOFA, MEWS, and NEWS in predicting in-hospital mortality in COVID-19 patients in the ED.
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