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Outcome prediction for patients assessed by the medical emergency team: a retrospective cohort study
Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID iD: 0000-0001-8150-3141
Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Adult Psychiatry, Mora Hospital, Mora, Sweden.
Health Metrics at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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2022 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 22, no 1, article id 200Article in journal (Refereed) Published
Abstract [en]

Background: Medical 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.

Methods: Observational 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.

Results: The 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).

Conclusions: Among 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.

 

Place, publisher, year, edition, pages
2022. Vol. 22, no 1, article id 200
Keywords [en]
Medical emergency team, Mortality, Outcome, Rapid response team, Risk score
National Category
Cardiac and Cardiovascular Systems
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-29225DOI: 10.1186/s12873-022-00739-wISI: 000896565200001PubMedID: 36494620Scopus ID: 2-s2.0-85143690329OAI: oai:DiVA.org:hb-29225DiVA, id: diva2:1725475
Funder
Swedish Heart Lung FoundationUniversity of GothenburgAvailable from: 2023-01-11 Created: 2023-01-11 Last updated: 2023-01-17Bibliographically approved

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Herlitz, Johan

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