Early Warning Scores in Emergency Department Patients Aged 80 Years or Older

Do early warning scores (EWSs) accurately predict short-term clinical deterioration among older patients in the emergency department (ED)?In this prognostic study including 50 645 Italian patients aged 80 years or older, 5 evaluated EWSs showed fair discrimination. The National Early Warning Score (NEWS) achieved the highest area under the curve, while the Rapid Emergency Medicine Score (REMS) showed superior calibration and positive predictive value and was the only score whose performance improved with increasing age.NEWS and its derivatives offered greater sensitivity, whereas REMS provided higher precision that may reduce alarm fatigue and outperformed other scores in older patients.

Corresponding Author: Nicola Bonadia, MD, Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 00168–Roma (nicola.bonadia@policlinicogemelli.it).

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