Outcome prediction for patients assessed by the medical emergency team: a retrospective cohort study

BMC Emergency Medicine

Research Article

Linda Pettersson¹  Pontus Forkman²  Anna Adielsson³  Stefan Lundin³  Christian Danielsson⁴  Thomas Karlsson⁵  Johan Herlitz⁶ 

[1] Center for Clinical Research Dalarna, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden;Department of Adult Psychiatry, Mora Hospital, Mora, Sweden;Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden;Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden;Health Metrics at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;The Center for Pre-Hospital Research in Western Sweden, University College of Borås, Borås, Sweden;

关键词: Medical emergency team;    Rapid response team;    Risk score;    Outcome;    Mortality;   

DOI  :  10.1186/s12873-022-00739-w

 received in 2022-03-01, accepted in 2022-10-26,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundMedical emergency teams (METs) have been implemented to reduce hospital mortality by the early recognition and treatment of potentially life-threatening conditions. The objective of this study was to establish a clinically useful association between clinical variables and mortality risk, among patients assessed by the MET, and further to design an easy-to-use risk score for the prediction of death within 30 days.MethodsObservational retrospective register study in a tertiary university hospital in Sweden, comprising 2,601 patients, assessed by the MET from 2010 to 2015. Patient registry data at the time of MET assessment was analysed from an epidemiological perspective, using univariable and multivariable analyses with death within 30 days as the outcome variable. Predictors of outcome were defined from age, gender, type of ward for admittance, previous medical history, acute medical condition, vital parameters and laboratory biomarkers. Identified factors independently associated with mortality were then used to develop a prognostic risk score for mortality.ResultsThe overall 30-day mortality was high (29.0%). We identified thirteen factors independently associated with 30-day mortality concerning; age, type of ward for admittance, vital parameters, laboratory biomarkers, previous medical history and acute medical condition. A MET risk score for mortality based on the impact of these individual thirteen factors in the model yielded a median (range) AUC of 0.780 (0.774–0.785) with good calibration. When corrected for optimism by internal validation, the score yielded a median (range) AUC of 0.768 (0.762–0.773).ConclusionsAmong clinical variables available at the time of MET assessment, thirteen factors were found to be independently associated with 30-day mortality. By applying a simple risk scoring system based on these individual factors, patients at higher risk of dying within 30 days after the MET assessment may be identified and treated earlier in the process.

【 授权许可】

CC BY   
© The Author(s) 2022

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