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. 2022 Jun 1;12(2):60-70.
doi: 10.6705/j.jacme.202206_12(2).0003.

The Role of NEWS2 + Lactate + D-Dimer in Predicting Intensive Care Unit Admission and In-Hospital Mortality of COVID-19 Patients

Kadir Küçükceran  1 , Mustafa Kürşat Ayrancı  1 , Zerrin Defne Dündar  1 , Muhammed İdris Keklik  1 , Hülya Vatansev  2
Affiliations

The Role of NEWS2 + Lactate + D-Dimer in Predicting Intensive Care Unit Admission and In-Hospital Mortality of COVID-19 Patients

Kadir Küçükceran et al. J Acute Med. .

Abstract

Background: We investigated the parameters of National Early Warning Score 2 (NEWS2) + lactate + D-dimer in predicting the intensive care unit (ICU) admission and in-hospital mortality in patients hospitalized with COVID-19.

Methods: Patients, who applied to the emergency department of a tertiary university hospital and were taken to the COVID-19 zone with suspected COVID-19 between March 2020 and June 2020, were retrospectively examined. In this study, 244 patients, who were hospitalized and had positive polymerase chain reaction test results, were included. NEWS2, lactate, and D-dimer levels of the patients were recorded. Patients were grouped by the states of in-hospital mortality and ICU admission.

Results: Of 244 patients who were included in the study, 122 (50%) were male, while their mean age was 53.76 ± 17.36 years. 28 (11.5%) patients were admitted to the ICU, while in-hospital mortality was seen in 14 (5.7%) patients. The levels of D-dimer, NEWS2, NEWS2 + lactate, NEWS2 + D-dimer, NEWS2 + lactate + D-dimer were statistically significantly higher in patients with in-hospital mortality and admitted to ICU ( p < 0.05). The area under the curve (AUC) values of D-dimer, lactate, NEWS2, NEWS2 + lactate, NEWS2 + D-dimer, NEWS2 + lactate + D-dimer in predicting ICU admission were as 0.745 (0.658-0.832), 0.589 (0.469-0.710), 0.760 (0.675-0.845), 0.774 (0.690-0.859), 0.776 (0.692-0.860), and 0.778 (0.694-0.862), respectively; while the AUC values of these parameters in predicting in-hospital mortality were found to be as 0.768 (0.671-0.865), 0.695 (0.563-0.827), 0.735 (0.634-0.836), 0.757 (0.647-0.867), 0.752 (0.656-0.848), and 0.764 (0.655-0.873), respectively.

Conclusions: Compared to using the NEWS2 value alone, a combination of NEWS2, lactate, and D-dimer was found to be more valuable in predicting in-hospital mortality and ICU admission.

Keywords: COVID-19; hospital mortality; intensive care unit.

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Figures

Fig. 1
Fig. 1. Receiver operating characteristic (ROC) curve by intensive care unit (ICU) admission.
Fig. 2
Fig. 2. Area under the curve (AUC) value for intensive care unit (ICU) admission.
Fig. 3
Fig. 3. Receiver operating characteristic (ROC) curve by in-hospital mortality.
Fig. 4
Fig. 4. Area under the curve (AUC) value for in-hospital mortality.
See this image and copyright information in PMC

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