Evaluation and comparison of diagnostic accuracy of early warning scores in the diagnosis of traumatic brain injury: a prospective study

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 ۲۰۲۳ to January ۲۰۲۵ at hospitalsaffiliated with Tehran University of Medical Sciences. Sampling was performed purposefully, andnon-randomly and ۲۵۰ trauma patients were enrolled in the study. Data collection was carried oututilizing a demographic questionnaire and various scoring systems, including the National EarlyWarning Score (NEWS۲), 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 ۴۰.۹۰±۱۵.۷۸. Accident (۵۶.۸%) was the most commonmechanism of trauma, and multiple trauma (۵۶%) was the most common type of trauma. TheNational Early Warning Score ۲ showed the highest diagnostic accuracy with sensitivity of ۸۲.۲%,specificity of ۸۱.۱%, and area under the curve of ۰.۸۸۹(. The results of the independent t-testshowed that the mean score of the NEWS۲ in prehospital care for patients with an initial diagnosis oftraumatic brain injury after ۷۲ hours (۱۲.۳±۲۹.۴) was significantly lower compared to other patients(۰۸.۳±۷۳.۷) (P<۰.۰۰۱).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 ۲ makes it a valuable tool in identifying patients with traumatic brain injury.

کلیدواژه ها:

Early warning score ، Trauma nursing ، Intensive care units