Comparison of five early warning scores in predicting mortality risk in patients presenting to the emergency department with acute dyspnea: qSOFA, NEWS2, MEWS, HASI, and SIL

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dc.contributor.authorSuzer, Neslihan
dc.contributor.authorALPAR, Suleyman
dc.contributor.authorTATLIPARMAK, ALI CANKUT
dc.contributor.authorYilmaz, Sarper
dc.date.accessioned2026-01-31T15:02:18Z
dc.date.available2026-01-31T15:02:18Z
dc.date.issued2025
dc.departmentİstanbul Beykent Üniversitesi
dc.description.abstractObjectives: This study aimed to compare five early warning scores - Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score 2 (NEWS2), Modified Early Warning Score (MEWS), Hospital Alert Severity Index (HASI), and Shock Index-Lactate (SIL) - in predicting 30-day mortality in elderly patients presenting to the emergency department (ED) with acute dyspnea. Methods: This was a single-center, retrospective observational study. A total of 764 patients aged 65 years or older presenting to the emergency department with acute dyspnea over a five-year period were included in this study. The predictive accuracy of each score was evaluated using AUROC analysis and logistic regression. Results: Our findings demonstrated that the qSOFA score had the highest accuracy in predicting 30-day mortality (AUROC: 0.768). Among these scores, qSOFA showed the best performance in predicting mortality with a sensitivity of 72.9% and specificity of 74.6%. In logistic regression analysis, the qSOFA score demonstrated the strongest independent association with 30-day mortality (odds ratio [OR]: 5.23, P<0.001). The SIL score also showed a significant association with mortality (OR: 1.29, P=0.035). However, the HASI (P=0.092), MEWS (P=0.726), and NEWS2 (P=0.344) scores were not independently significant in multivariable analysis. Regarding mortality timing, qSOFA was identified as the most robust predictor for early death (within the first 3 days) with an AUROC of 0.801. It also demonstrated superior performance in predicting late in-hospital death (after 3 days) with an AUROC of 0.632 and post-discharge mortality within 30 days with an AUROC of 0.788. Other scores (HASI, MEWS, NEWS2, SIL) demonstrated lower performance in predicting mortality across different time intervals. Conclusions: qSOFA demonstrated the most consistent and accurate performance among the evaluated scores. It may serve as a practical tool for early risk stratification in elderly patients with acute dyspnea in ED settings.
dc.identifier.doi10.18621/eurj.1738116
dc.identifier.endpage857
dc.identifier.issn2149-3189
dc.identifier.issue5
dc.identifier.startpage845
dc.identifier.trdizinid1339342
dc.identifier.urihttps://doi.org/10.18621/eurj.1738116
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay/1339342
dc.identifier.urihttps://hdl.handle.net/20.500.12662/10390
dc.identifier.volume11
dc.indekslendigikaynakTR-Dizin
dc.language.isoen
dc.relation.ispartofThe European Research Journal
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_TR-Dizin_20260128
dc.subjectElderly
dc.subjectemergency department
dc.subjectDyspnea
dc.subjectearly warning score
dc.subjectqSOFA
dc.titleComparison of five early warning scores in predicting mortality risk in patients presenting to the emergency department with acute dyspnea: qSOFA, NEWS2, MEWS, HASI, and SIL
dc.typeArticle

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