Exploring the value of routinely measured hematology parameters for identification of elderly patients at high risk of death at the Emergency Department.

Autor:	Bindraban RS; Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands., Ten Berg MJ; Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands., Haitjema S; Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands., Hoefer IE; Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands., de Regt M; Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., Kramer M; Section Acute Medicine, Department of Internal Medicine, Amsterdam University Medical Centers, VU University Medical Center, Amsterdam, The Netherlands., van Solinge WW; Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands., Nanayakkara P; Section Acute Medicine, Department of Internal Medicine, Amsterdam University Medical Centers, VU University Medical Center, Amsterdam, The Netherlands., Naaktgeboren CA; Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Acute medicine [Acute Med] 2018; Vol. 17 (4), pp. 188-202.
Abstrakt:	Of the warning scores in use for recognition of high-risk patients at the Emergency Department (ED), few incorporate laboratory results. Although hematological characteristics have shown prognostic value in small studies, large studies in elderly ED populations are lacking. We studied the association between blood cell and platelet counts and characteristics as well as C-reactive protein (CRP) at ED presentation with mortality in non-multitrauma patients ≥ 65 years. Comparison between survivors and non-survivors showed small, significant differences with AUROCs ranging between 56.6% and 65.2% for 30-day mortality. Combining parameters yielded an evident improvement (AUROC of 70.4%). Efforts should be pursued to study the added value of hematological parameters on top of clinical data when assessing patient risk.
Databáze:	MEDLINE
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