Accuracy of prognostic scoring tools for ICU triage and mortality among patients in low- and middle-income countries: a systematic review and meta-analysis.
Rapid Emergency Medicine Score best predicted intensive care admission in low- and middle-income countries
Accuracy of prognostic scoring tools for ICU triage and mortality among patients in low- and middle-income countries: a systematic review and meta-analysis.
Early warning and severity scores are widely used to support triage and predict clinical deterioration.
This study aimed to evaluate and compare the diagnostic accuracy of commonly used scoring systems for predicting intensive care unit (intensive care unit) admission and in-hospital mortality among adults presenting to emergency departments in low- and middle-income countries.
We conducted a systematic review and meta-analysis of PubMed, Science Direct, Web of Science and the Cochrane Library.
For in-hospital mortality, quick Sequential Organ Failure Assessment (qSOFA) showed sensitivity of 0.61 and specificity of 0.73 (AUC=0.67); National Early Warning Score (National Early Warning Score)-family had higher sensitivity (0.80) but lower specificity (0.56, AUC=0.68); Modified Early Warning Score (Modified Early Warning Score) provided high specificity (0.83) but lower sensitivity (0.53, AUC=0.68).
Considerable heterogeneity was observed across studies.
Early warning scores show moderate accuracy in predicting intensive care unit admission and in-hospital mortality in low- and middle-income countries emergency departments.
qSOFA and Modified Early Warning Score may be most useful when high specificity is required, while National Early Warning Score and Rapid Emergency Medicine Score provide more balanced performance, with Rapid Emergency Medicine Score showing the best overall accuracy.
No single score was optimal across settings, underscoring the need for local validation and adaptation in resource-limited environments.