Evaluation and Comparison of Diagnostic Accuracy of Early Warning Scores in the Diagnosis of Traumatic Brain Injury: A Prospective Study Publisher



Ganji M ; Navab E ; Haghani S ; Shali M
Source: Journal of Emergency Practice and Trauma Published:2024

Abstract

Objective: When dealing with patients with possible traumatic brain injury, prehospital emergency personnel must make decisions quickly with very little data. Determining the amount of risk that threatens patients can lead to making correct treatment decisions. The present study aimed to determine and compare the diagnostic accuracy of early warning scores in prehospital care for the diagnosis of traumatic brain injury. Methods: This prospective study was conducted from December 2023 to January 2025 at hospitals affiliated with Tehran University of Medical Sciences. Sampling was performed purposefully, and non-randomly and 250 trauma patients were enrolled in the study. Data collection was carried out utilizing a demographic questionnaire and various scoring systems, including the National Early Warning 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 common mechanism of trauma, and multiple trauma (56%) was the most common type of trauma. The National 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-test showed that the mean score of the NEWS2 in prehospital care for patients with an initial diagnosis of traumatic 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 were significant differences in their performance measures. The higher diagnostic accuracy of the National Early Warning Score 2 makes it a valuable tool in identifying patients with traumatic brain injury. © 2024 The Author(s).