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Background <p>Early identification of high-risk patients in emergency departments (EDs) is crucial. This study compares the prognostic value of the National Early Warning Score-2 (NEWS-2), Modified Early Warning Score (MEWS), and Peripheral Perfusion Index (PPI).</p> Aims <p>To compare the performance of NEWS-2, MEWS, and PPI in predicting 30-day mortality among critically ill patients admitted to the intensive care unit.</p> Methods <p>A prospective, observational study (June–October 2024) included 306 critically ill patients. NEWS-2, MEWS, and PPI were recorded upon presentation. The primary outcome was 30-day mortality. ROC analysis was used to determine the area under the curve (AUC), sensitivity, and specificity.</p> Results <p>The 30-day mortality rate was 29.7% (n = 91). Significant differences were found in all scores between survivors and non-survivors (p &lt; .001). NEWS-2 demonstrated the highest discrimination (AUC 0.666; 95% CI 0.598–0.733), followed by MEWS (AUC 0.643) and PPI (AUC 0.633). While NEWS-2 (cutoff ≥ 6) provided the highest sensitivity at 71.4%, the PPI (cutoff ≤ 1.15) exhibited the highest specificity at 78.6%.</p> Conclusions <p>NEWS-2 remains the strongest single predictor for 30-day mortality. However, the PPI offers high specificity and reflects microcirculatory impairment, making it a valuable complementary tool alongside established early warning scores rather than a replacement.</p>

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Early warning scores and peripheral perfusion index: A Comparative assessment for 30-day mortality in critical patients in emergency departments

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月10日

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  • Ahmet Celal Ozsoy,
  • Huseyin Avni Demir,
  • Mustafa Simsek,
  • Ahmet Celik,
  • Muhammed Tabası,
  • Zahit Donmez,
  • Abdul Samed Rayan,
  • Eyyup Sabri Seyhanli

摘要

Background

Early identification of high-risk patients in emergency departments (EDs) is crucial. This study compares the prognostic value of the National Early Warning Score-2 (NEWS-2), Modified Early Warning Score (MEWS), and Peripheral Perfusion Index (PPI).

Aims

To compare the performance of NEWS-2, MEWS, and PPI in predicting 30-day mortality among critically ill patients admitted to the intensive care unit.

Methods

A prospective, observational study (June–October 2024) included 306 critically ill patients. NEWS-2, MEWS, and PPI were recorded upon presentation. The primary outcome was 30-day mortality. ROC analysis was used to determine the area under the curve (AUC), sensitivity, and specificity.

Results

The 30-day mortality rate was 29.7% (n = 91). Significant differences were found in all scores between survivors and non-survivors (p < .001). NEWS-2 demonstrated the highest discrimination (AUC 0.666; 95% CI 0.598–0.733), followed by MEWS (AUC 0.643) and PPI (AUC 0.633). While NEWS-2 (cutoff ≥ 6) provided the highest sensitivity at 71.4%, the PPI (cutoff ≤ 1.15) exhibited the highest specificity at 78.6%.

Conclusions

NEWS-2 remains the strongest single predictor for 30-day mortality. However, the PPI offers high specificity and reflects microcirculatory impairment, making it a valuable complementary tool alongside established early warning scores rather than a replacement.