Comparison of seven prehospital early warning scores to predict long-term mortality: a prospective, multicenter, ambulance-based study.

Autor:	Martín-Rodríguez F; Advanced Clinical Simulation Center, Faculty of Medicine, Universidad de Valladolid.; Advanced Life Support, Emergency Medical Services (SACYL).; Prehospital Early Warning Scoring-System Investigation Group., Enriquez de Salamanca Gambara R; Emergency Department, Hospital Universitario Rio Hortega, Valladolid., Sanz-García A; Prehospital Early Warning Scoring-System Investigation Group.; Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina., Castro Villamor MA; Advanced Clinical Simulation Center, Faculty of Medicine, Universidad de Valladolid.; Prehospital Early Warning Scoring-System Investigation Group., Del Pozo Vegas C; Advanced Clinical Simulation Center, Faculty of Medicine, Universidad de Valladolid.; Prehospital Early Warning Scoring-System Investigation Group.; Emergency Department, Hospital Clínico Universitario, Valladolid, Spain., Sánchez Soberón I; Advanced Life Support, Emergency Medical Services (SACYL)., Delgado Benito JF; Advanced Life Support, Emergency Medical Services (SACYL).; Prehospital Early Warning Scoring-System Investigation Group., Martín-Conty JL; Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, Universidad de Castilla la Mancha, Talavera de la Reina., López-Izquierdo R; Advanced Clinical Simulation Center, Faculty of Medicine, Universidad de Valladolid.; Prehospital Early Warning Scoring-System Investigation Group.; Emergency Department, Hospital Universitario Rio Hortega, Valladolid.
Jazyk:	angličtina
Zdroj:	European journal of emergency medicine : official journal of the European Society for Emergency Medicine [Eur J Emerg Med] 2023 Jun 01; Vol. 30 (3), pp. 193-201. Date of Electronic Publication: 2023 Apr 05.
DOI:	10.1097/MEJ.0000000000001019
Abstrakt:	Methods: A prospective, multicenter, ambulance-based study of adult patients with an acute illness involving six advanced life support units and 38 basic life support units, referring to five emergency departments in Spain. Results: The primary outcome was long-term mortality with a 1-year follow-up. The compared scores included: National Early Warning Score 2, VitalPAC early warning score, modified rapid emergency medicine score (MREMS), Sepsis-related Organ Failure Assessment, Cardiac Arrest Risk Triage Score, Rapid Acute Physiology Score, and Triage Early Warning Score. Discriminative power [area under the receiver operating characteristic curve (AUC)] and decision curve analysis (DCA) were used to compare the scores. Additionally, a Cox regression and Kaplan-Meier method were used. Between 8 October 2019, and 31 July 2021, a total of 2674 patients were selected. The MREMS presented the highest AUC of 0.77 (95% confidence interval, 0.75-0.79), significantly higher than those of the other EWS. It also exhibited the best performance in the DCA and the highest hazard ratio for 1-year mortality [3.56 (2.94-4.31) for MREMS between 9 and 18 points, and 11.71 (7.21-19.02) for MREMS > 18]. Conclusion: Among seven tested EWS, the use of the MREMS presented better characteristics to predict 1-year mortality; however, all these scores present moderate performances. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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