Comparison of NEWS2 and CURB65 Score in Predicting Mortality of Hospitalized patients with AECOPD

Neelam Kumari, Aneel Kumar, Raniyah Akhter, Nausheen Saifullah
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Abstract

Aim: To determine the diagnostic accuracy of the NEWS2 and CURB-65 scores in predicting in-hospital mortality in patients with acute exacerbations of COPD, mortality during hospital stays is considered the gold standard. Study Design: Cross-sectional study-design. Place and duration of study: Department of Chest Medicine, JPMC, Karachi, from September 25, 2020, to January 25, 2021. Two hundred and twelve patients of both genders were included who were admitted because of acute COPD exacerbations. The National Early Warning Score 2 (NEWS2) and CURB-65 Score in the estimation and evaluation of hospital-related mortality were noted. Results: NEWS2 predicted 156(73.6%), CURB-65 predicted 72(34%) as high-risk patients, and in-hospital mortality was 39(18.4%). NEWS2 had shown sensitivity of 100%, specificity of 32.4%, diagnostic accuracy of 45%, PPV of 25.1%, and NPV of 100% as a prediction value of in-hospital mortality. CURB-65 had shown sensitivity of 76.9%, specificity of 75.7%, and diagnostic accuracy of 76%, PPV of 41.7%, and NPV of 93.6% as a prediction value of in-hospital mortality. Implication: It is recommended that individual analyses of these associated factors be performed in future studies for the formulation of novel, efficient scores that may be better predictors of mortality in AECOPD patients. Conclusion: Both of the scoring systems can be used for the purpose of AECOPD patients risk stratification as per clinicians’ preference and as the basic tools of assessment in a resource-poor country. Keywords: Acute exacerbation of COPD, NEWS2, CURB-65, In-hospital mortality
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比较 NEWS2 和 CURB65 评分在预测 AECOPD 住院患者死亡率方面的作用
目的:确定 NEWS2 和 CURB-65 评分在预测慢性阻塞性肺病急性加重患者院内死亡率方面的诊断准确性。研究设计:横断面研究设计。研究地点和持续时间2020年9月25日至2021年1月25日,卡拉奇JPMC医院胸科。研究对象包括 212 名因慢性阻塞性肺疾病急性加重而入院的男女患者。在估计和评估住院相关死亡率时,注意到了国家预警评分 2(NEWS2)和 CURB-65 评分。结果NEWS2预测156人(73.6%)为高危患者,CURB-65预测72人(34%)为高危患者,院内死亡率为39人(18.4%)。作为院内死亡率的预测值,NEWS2 的灵敏度为 100%,特异性为 32.4%,诊断准确率为 45%,PPV 为 25.1%,NPV 为 100%。CURB-65 预测院内死亡率的灵敏度为 76.9%,特异性为 75.7%,诊断准确性为 76%,PPV 为 41.7%,NPV 为 93.6%。意义:建议在今后的研究中对这些相关因素进行单独分析,以制定新颖、有效的评分标准,从而更好地预测 AECOPD 患者的死亡率。结论:这两种评分系统均可根据临床医生的偏好用于 AECOPD 患者的风险分层,也可作为资源匮乏国家的基本评估工具。关键词慢性阻塞性肺疾病急性加重 NEWS2 CURB-65 院内死亡率
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