A clinical prediction model to identify patients at high risk of death in the emergency department

Intensive Care Medicine
Michael CoslovskyTobias M Merz

Abstract

Rapid assessment and intervention is important for the prognosis of acutely ill patients admitted to the emergency department (ED). The aim of this study was to prospectively develop and validate a model predicting the risk of in-hospital death based on all available information available at the time of ED admission and to compare its discriminative performance with a non-systematic risk estimate by the triaging first health-care provider. Prospective cohort analysis based on a multivariable logistic regression for the probability of death. A total of 8,607 consecutive admissions of 7,680 patients admitted to the ED of a tertiary care hospital were analysed. Most frequent APACHE II diagnostic categories at the time of admission were neurological (2,052, 24%), trauma (1,522, 18%), infection categories [1,328, 15%; including sepsis (357, 4.1%), severe sepsis (249, 2.9%), septic shock (27, 0.3%)], cardiovascular (1,022, 12%), gastrointestinal (848, 10%) and respiratory (449, 5%). The predictors of the final model were age, prolonged capillary refill time, blood pressure, mechanical ventilation, oxygen saturation index, Glasgow coma score and APACHE II diagnostic category. The model showed good discriminative ability, with an area ...Continue Reading

References

Mar 1, 1991·Annals of Emergency Medicine·S G Lynn, A L Kellermann
Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Apr 1, 1996·Annals of Emergency Medicine·J C BrillmanB J Skipper
Jun 19, 1998·BMJ : British Medical Journal·P McQuillanC H Collins
Dec 30, 1999·Annals of Emergency Medicine·R W Derlet, J R Richards
Sep 1, 2001·Journal of Advanced Nursing·M F Gerdtz, T K Bucknall
May 17, 2002·Special Care in Dentistry : Official Publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry·Stella ChaushuJoseph Shapira
Nov 5, 2002·Intensive Care Medicine·Ken M HillmanGrant Simmons
Sep 11, 2003·The Medical Journal of Australia·Rinaldo BellomoGeoffrey Gutteridge
Aug 25, 2004·Resuscitation·Juliane KauseUNKNOWN Australian and New Zealand Intensive Care Society Clinical Trials Group
Oct 22, 2004·Emergency Medicine Journal : EMJ·J E Rees, C Mann
Feb 2, 2006·Clinical Chemistry·Paul Froom, Zvi Shimoni
Apr 22, 2006·Emergency Medicine Journal : EMJ·S GoodacreJ Nicholl
Oct 24, 2006·Emergency Medicine Journal : EMJ·C P SubbeL Gemmell
Feb 6, 2008·Resuscitation·Gary B SmithPeter I Featherstone
Mar 26, 2009·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Jonas QuittPeter Tschudi
Jun 23, 2009·Journal of Medical Genetics·D RamsoekhE W Steyerberg
Feb 12, 2010·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Mikkel BrabrandJesper Hallas
Jul 20, 2010·Resuscitation·David R PrytherchPeter I Featherstone
Aug 19, 2010·JAMA : the Journal of the American Medical Association·Christopher W SeymourThomas D Rea
Jan 8, 2011·Emergency Medicine Journal : EMJ·Kirsty Challen, Steve W Goodacre
Nov 2, 2011·BMC Emergency Medicine·Anne-Claire DurandRoland Sambuc
Feb 27, 2014·Intensive Care Medicine·José LabarèreMichael J Fine

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Citations

May 15, 2015·Intensive Care Medicine·Christian Mélot
Jun 3, 2016·Intensive Care Medicine·Alain CariouAnders Aneman
Nov 15, 2018·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Magnolia CardonaDorothy Breen
Jul 15, 2018·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Vincent M QuintenJan C Ter Maaten
Jan 26, 2020·Artificial Intelligence in Medicine·Marta FernandesJoão M C Sousa
Aug 31, 2020·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Alireza AlaSina Parsay

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