Evaluation and comparison of diagnostic accuracy of early warning scores in the diagnosis of traumatic brain injury: a prospective study
نویسندگان
1 Department of Critical Care Nursing, Tehran School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
2 Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
3 Department of Critical Care Nursing, Tehran School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
4 1 Department of Emergency Care Nursing, Tehran School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
doi
10.34172/jept.2025.12چکیده
Objective: When dealing with patients with possible traumatic brain injury, prehospital emergencypersonnel must make decisions quickly with very little data. Determining the amount of risk thatthreatens patients can lead to making correct treatment decisions. The present study aimed todetermine and compare the diagnostic accuracy of early warning scores in prehospital care for thediagnosis of traumatic brain injury.Methods: This prospective study was conducted from December 2023 to January 2025 at hospitalsaffiliated with Tehran University of Medical Sciences. Sampling was performed purposefully, andnon-randomly and 250 trauma patients were enrolled in the study. Data collection was carried oututilizing a demographic questionnaire and various scoring systems, including the National EarlyWarning Score (NEWS2), Modified Early Warning Score (MEWS), Triage Early Warning Score (TEWS),and Modified Emergency Medical Score (MEMS). The data were analyzed using SPSS software.Results: The mean age of the patients was 40.90±15.78. Accident (56.8%) was the most commonmechanism of trauma, and multiple trauma (56%) was the most common type of trauma. TheNational Early Warning Score 2 showed the highest diagnostic accuracy with sensitivity of 82.2%,specificity of 81.1%, and area under the curve of 0.889(. The results of the independent t-testshowed that the mean score of the NEWS2 in prehospital care for patients with an initial diagnosis oftraumatic brain injury after 72 hours (12.3±29.4) was significantly lower compared to other patients(08.3±73.7) (P<0.001).Conclusion: While all four early warning scores were good at detecting ICU admission, there weresignificant differences in their performance measures. The higher diagnostic accuracy of the NationalEarly Warning Score 2 makes it a valuable tool in identifying patients with traumatic brain injury.