Comparison of risk scores in the estimation of short-term mortality of critically ill elder patients admitted to the emergency department

Aim: The aim of this study was to investigate the short-term mortality of critically ill elder patients who were admitted to the emergency department using the National Early Warning Score (NEWS), Rapid Emergency Medicine Score (REMS), VITALPAC Early Warning Score (ViEWS) and Emergency Department Triage Early Warning Score (TREWS). Methods: This prospective study was conducted in Bursa Uludag University Faculty of Medicine Emergency Medicine Department between 16 April 2022 and 31 December 2022. At that time, 311 cases aged 65 years and older who applied to the Emergency Department with non-traumatic causes were included in the study. NEWS, REMS, VIEWS and TREWS scores were recorded in the Emergency Department admission time. Results: The mean age of the patients was 75.05±7.18 years. The most common etiological cause for admission was shortness of breath with a rate of 36.3%.The male gender was more common and the most common disease was chronic heart disease. According to the Manchester Triage Skore (MTS), 39.2% were in the red category and 60.8% were in the orange category. 46% of the patients were discharged, 25% were admitted to the clinical wards, 26% were admitted to the intensive care unit, and 3% refused treatment and left the emergency room. While 87.5% of the patients were alive at the end of 30 days, 12.5% were exitus. Mortality was significantly higher in those with red MTS scores and those given oxygen supplementation (p<0.001). Mortality was lower in patients who were evaluated as alert on the AVPU scale (p<0.001). When the cut-off point of the NEWS score was accepted as 6, its sensitivity IX was 50.0%, its specificity was 89.89%, its sensitivity was 65.89% when the cutting point of the VIEWS score was accepted as 3, its specificity was 71.16%, its sensitivity was 36.84% when the cutting point of the TREWS score was accepted as 8, its specificity was 93.26%, and its sensitivity was 89.47% when the cutting point of the REMS score was accepted as 5, and its specificity was 25.84%. NEWS, TREWS and VIEWS scores were associated with increased mortality (p<0.001). Conclusion: NEWS, TREWS and VIEWS scores can be used to estimate short-term mortality in elderly patients admitted to the emergency department. Keywords: Emergency department, elder , NEWS, VIEWS, TREWS