Impact of point-of-care biomarkers on the improvement of the predictive capacity of early warning scores in prehospital care: a systematic review and meta-analysis.
Emergencias · 2025-08-01 · Meta-analysis
Abstract
OBJECTIVE: The use of early warning scores and prehospital blood testing is a current reality in prehospital emergency medical systems. However, there is limited evidence regarding the benefit of incorporating point-of-care biomarkers alongside these scores. The aim of this study was to compare the predictive capacity of scores that include biomarkers with those based solely on vital signs. METHODS: We conducted a systematic search across Medline (via PubMed), Web of Science, Cochrane Library, and Scopus databases for studies evaluating the ability of early warning scores and blood biomarkers to predict short-term mortality. A subsequent meta-analysis was performed to compare the effectiveness of scores based solely on physiological parameters with those incorporating analytical parameters. RESULTS: A total of 9 studies were selected from the systematic review and included in the meta-analysis for meeting the predefined inclusion criteria. The pooled mean sensitivity was 0.619 (0.489-0.734) with biomarkers and 0.627 (0.538-0.708) without them; specificity was 0.809 (0.763-0.848) and 0.699 (0.653-0.742), and the diagnostic odds ratio was 6.839 (2.617-17.872) and 3.928 (2.811-5.491), respectively, for the scores with and without biomarkers. Significant differences were found for specificity (P .001), but not for sensitivity (P = .917) or the odds ratio (P = .285). CONCLUSIONS: The inclusion of parameters derived from prehospital point-of-care testing in early warning scores provides a benefit to prehospital care, as it improves the identification of patients who will not experience short-termmortality by increasing specificity.
Tags
Early warning scores · Mortality & survival · Point-of-care tests