Early warning scores and peripheral perfusion index: A Comparative assessment for 30-day mortality in critical patients in emergency departments
Irish Journal of Medical Science, cilt.195, sa.4, ss.2393-2398, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 195 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11845-026-04358-3
- Dergi Adı: Irish Journal of Medical Science
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.2393-2398
- Anahtar Kelimeler: Critical illness, NEWS-2, MEWS, Peripheral perfusion index, Mortality prediction
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Early identification of high-risk patients in emergency departments (EDs) is crucial. This study compares the prognostic value of the National Early Warning Score-2 (NEWS-2), Modified Early Warning Score (MEWS), and Peripheral Perfusion Index (PPI). Aims: To compare the performance of NEWS-2, MEWS, and PPI in predicting 30-day mortality among critically ill patients admitted to the intensive care unit. Methods: A prospective, observational study (June–October 2024) included 306 critically ill patients. NEWS-2, MEWS, and PPI were recorded upon presentation. The primary outcome was 30-day mortality. ROC analysis was used to determine the area under the curve (AUC), sensitivity, and specificity. Results: The 30-day mortality rate was 29.7% (n = 91). Significant differences were found in all scores between survivors and non-survivors (p <.001). NEWS-2 demonstrated the highest discrimination (AUC 0.666; 95% CI 0.598–0.733), followed by MEWS (AUC 0.643) and PPI (AUC 0.633). While NEWS-2 (cutoff ≥ 6) provided the highest sensitivity at 71.4%, the PPI (cutoff ≤ 1.15) exhibited the highest specificity at 78.6%. Conclusions: NEWS-2 remains the strongest single predictor for 30-day mortality. However, the PPI offers high specificity and reflects microcirculatory impairment, making it a valuable complementary tool alongside established early warning scores rather than a replacement.