Goodacre et al reported the PRIEST score for the triage of a patient with COVID-19. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in England.
PRIEST = Pandemic Respiratory Infection Emergency System Triage
Patient selection: COVID-19, >= 16 years of age, in the Emergency Department
Outcome: adverse outcome with 30 days of visit (death, major organ support)
Parameters:
(1) respiratory rate in breaths per minute
(2) oxygen saturation in percent
(3) heart rate in beats per minute
(4) systolic blood pressure in mm Hg
(5) body temperature in °C
(6) alertness
(7) inspired oxygen
(8) sex
(9) age
(10) performance status (possibly based on ECOG performance status)
|
Performance |
Findings |
Points |
|
respiratory rate |
< 9 |
3 |
|
|
9 to 11 |
1 |
|
|
12 to 20 |
0 |
|
|
21 to 24 |
2 |
|
|
> 24 |
3 |
|
oxygen saturation |
> 95% |
0 |
|
|
94 to 95% |
1 |
|
|
92 to 93% |
2 |
|
|
< 92% |
3 |
|
heart rate |
< 41 |
3 |
|
|
41 to 50 |
1 |
|
|
51 to 90 |
0 |
|
|
91 to 110 |
1 |
|
|
111 to 130 |
2 |
|
|
> 130 |
3 |
|
systolic blood pressure |
< 91 |
3 |
|
|
91 to 100 |
2 |
|
|
101 to 110 |
1 |
|
|
111 to 219 |
0 |
|
|
> 219 |
3 |
|
body temperature |
< 35.1 |
3 |
|
|
35.1 to 36.0 |
1 |
|
|
36.1 to 38.0 |
0 |
|
|
38.1 to 39 |
1 |
|
|
> 39 |
2 |
|
alertness |
alert |
0 |
|
|
not alert, confused |
3 |
|
inhaled oxygen |
room air |
0 |
|
|
supplemental oxygen |
2 |
|
sex |
female |
0 |
|
|
male |
1 |
|
age in years |
16 to 49 |
0 |
|
|
50 to 65 |
2 |
|
|
66 to 80 |
3 |
|
|
> 80 |
4 |
|
performance status |
unrestricted, normal activity |
0 |
|
|
limited strenuous activity |
1 |
|
|
limited activity, can do self-care |
2 |
|
|
limited self-care |
3 |
|
|
no self-care, bed or chair bound |
4 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 29
|
Score |
Percent Adverse Outcome |
|
0 or 1 |
1% |
|
2 or 3 |
2% |
|
4 |
3% |
|
5 |
9% |
|
6 |
15% |
|
7 |
19% |
|
8 |
22% |
|
9 |
26% |
|
10 |
29% |
|
11 |
34% |
|
12 |
38% |
|
13 |
46% |
|
14 |
47% |
|
15 |
49% |
|
16 |
55% |
|
17 |
60% |
|
18 |
69% |
|
19 |
71% |
|
20 |
56% |
|
21 |
69% |
|
22 |
67% |
|
23 |
79% |
|
24 |
80% |
|
25 |
88% |
|
26 |
67% |
|
27 to 29 |
100% |
Performance:
• The area under the ROC curve is 0.80
Purpose: To evaluate a patient with COVID-19 in the Emergency Department using the PRIEST score of Goodacre et al.
Specialty: Infectious Diseases
Objective: severity, prognosis, stage
ICD-10: U07.1,
