Comparison of early warning scores in predicting mortality in non-trauma patients presenting to the emergency department

Rapid Emergency Medicine Score (REMS), Rapid Acute Physiology Score (RAPS), and Worthing Physiological Scoring (WPS) systems are simple tools that can be readily used in the emergency department (ED) to predict patient outcomes, as they involve few variables. To determine the predictive accuracy of RAPS, REMS, and WPS in predicting all-cause mortality at 30 days and 7 days in non-trauma patients presenting to the ED. Methods: This longitudinal study included all patients aged above 18 years who presented to the ED. A convenient sampling technique was used, and the total sample size was 1328. The primary outcome was 30-day mortality, and the secondary outcome was 7-day mortality. Receiver operating characteristic (ROC) curves were constructed for RAPS, REMS, and WPS to determine optimal cut-off values for mortality prediction at 7 and 30 days. A total of 1328 adults were evaluated. The overall 7-day mortality rate was 6.6%, and the 30-day mortality rate was 11.3%. At 7 days, RAPS had an AUC of 0.914 (95% CI 0.889–0.939, p < 0.001), REMS 0.851 (95% CI 0.814–0.885, p < 0.001), and WPS 0.882 (95% CI 0.854–0.911, p < 0.001). At 30 days, RAPS had an AUC of 0.933 (95% CI 0.913–0.952, p < 0.001), REMS 0.878 (95% CI 0.852–0.904, p < 0.001), and WPS 0.911 (95% CI 0.892–0.931, p < 0.001). RAPS demonstrated superior predictive accuracy for 7-day mortality, while both RAPS and WPS showed better predictive accuracy for 30-day mortality in non-trauma ED patients.