• Pedro Arévalo-Buitrago, Ignacio Morales-Cané, Estefanía Olivares Luque, Ipek Guler, María Aurora Rodríguez-Borrego, and Pablo Jesús López-Soto.
• Departamento de Enfermería, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España. Hospital de Montilla, Córdoba, España.
• Emergencias. 2021 Oct 1; 33 (5): 374381374-381.

ObjectivesTo assess the predictive power of scores used in hospital emergency departments (EDs) to give early warning of risk for mortality and hospital ward or intensive care unit (ICU) admission.Material And MethodsSystematic review and meta-analysis. We searched MEDLINE, Embase, the Web of Science, and the Cochrane Library. Observational studies and clinical trials published between January 1, 1950, and June 12, 2020 that used early-warning scores in hospital EDs were included. The main outcomes were mortality (at 24, 48, and more than 72 hours), hospital admission, and ICU admission.ResultsNine studies entered into the systematic review; 4 of them, with 165 580 patients, were included in the meta-analysis. The studies were heterogeneous with respect to the scores used. The one used most often was the National Early Warning Score (NEWS). The meta-analysis of studies using the NEWS scale showed that it had good predictive power for mortality: the area under the curve (AUC) of the receiver operating characteristic was 0.88 (95%, CI, 0.87-0.89; P .001, I2 = 0%) at 24 hours and 0.86 (0.84-0.88; P .001; I2 = 49.3%) at 48 hours. The AUC for inhospital mortality was 0.77 (95% CI, 0.74-0.80; P .001; I2 = 96.2%). The NEWS score had adequate power for predicting risk of hospital ward and ICU admission.ConclusionEarly warning scores used in hospital EDs are able to predict risk of early and in-hospital mortality.

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