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Master Thesis

Évaluation de la pertinence du score Early Warning Score O2 « EWS.O2 » chez les patients admis aux urgences pour pathologie à Covid-19

Abstract : Introduction: Early warning scores have been developed to early detect a deterioration of the patient's condition in service and thus prevent serious adverse events leading to in-hospital cardiorespiratory arrest and death. In 2020, a new score "EWS.O2" was created. This one can be automated and is using for the first time an estimation of the inspired fraction of oxygen (FiO2) based on the oxygen flow brought to the patient in spontaneous ventilation. This score was studied in patients admitted to the emergency department for dyspnea of any cause and showed equivalence and even superiority to existing scores for admission to the intensive care unit, death in the emergency department and the use of non-invasive ventilation/high flow oxygen therapy, using only the vital parameters at patient intake. Our objective was to evaluate the performance of this score in the population of patients admitted to the emergency department for pathology in Covid-19. Methods: All patients admitted to the emergency department of the Grenoble University Hospital from March 2020 to February 2021 for confirmed Covid-19 pathology and having all vital parameters useful for the calculation of the score were included. The performance of the score was evaluated by making ROC curves and by calculating the area under the curve for the composite primary endpoint "admission to intensive care and/or death within 48 hours". The cut-off values of this score were re-evaluated according to the calculation of sensitivity, specificity, negative predictive value and positive predictive value for this population. Results: 389 patients were included, 83 of whom had the composite primary endpoint of severity. The area under the ROC curve was 0.667 (CI95% 0.607 - 0.728). An EWS.O2 score of 4.66 allowed a sensitivity >0.9 with a negative predictive value of 0.92, a specificity of 0.32 and a positive predictive value of 0.27. Conclusion: The performance of the EWS.O2 score in Covid-19 patients admitted to the emergency department appears moderate, and the cut-off value of 4.66 allows for a severity exclusion attitude in this population. The automated measurement of vital parameters and the automatic calculation of this score for the early detection of an unfavorable evolution could allow a better allocation of the level of care and the monitoring of dyspneic Covid-19 patients, by taking into account the couple ventilatory frequency / FiO2
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03419404
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Monday, November 8, 2021 - 2:28:08 PM
Last modification on : Wednesday, November 10, 2021 - 3:35:08 AM

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Laura Cellier. Évaluation de la pertinence du score Early Warning Score O2 « EWS.O2 » chez les patients admis aux urgences pour pathologie à Covid-19. Médecine humaine et pathologie. 2021. ⟨dumas-03419404⟩

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