Comparison of national early warning score-2 and qSOFA in predicting the prognosis of older adults with altered mental status.

Background: Altered mental status occurs in one in four older adults, and the risk increases with age. Numerous scoring systems have been improved to predict mortality, but data are limited for these scoring systems to interpret older adult patients.

Aim: We aimed to compare qSOFA and National Early Warning Score-2 (NEWS2) scores in predicting the prognosis of older adults with altered mental status.

Method: We included 500 older adults with altered mental status. We noted the qSOFA and NEWS2 scores of the patients. We compared the qSOFA and NEWS2 scores for the prediction of 30-day mortality, 48-h mortality, hospitalization clinic, outcome, and hospitalization length.

Results: The mean NEWS2 score was 6.4, and the mean qSOFA score was 1.3. For 30-day mortality, the sensitivity and specificity of the NEWS2 score ≥ 5 were 68.29% and 69.6%, respectively, and those of qSOFA score > 1 were 47.14% and 78.75%, respectively. AUC values for 30-day mortality prediction were 0,725 (CI: 0.683-0.763) and 0.631 (CI: 0.587-0.673). For intensive care unit hospitalization prediction, the sensitivity and specificity of the NEWS2 score ≥ 5 were 52.73% and 77.67%, respectively, and those of qSOFA score > 1 were 35.32% and 81.55%, respectively. In patients with a NEWS2 score > 10 points, the predicted 48-h mortality had a specificity of 80.6%, which was higher than the qSOFA score.

Conclusion: NEWS2 score can be used to predict 48-h mortality, 30-day mortality, and intensive care unit hospitalization compared with qSOFA in older adults with altered mental status.