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  • Adielsson, AnnaDepartment of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Dept Anaesthesiol & Intens Care Med, Gothenburg, Sweden. (author)

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

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2022-12-09
  • Springer Science and Business Media LLC,2022
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:hb-29225
  • https://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-29225URI
  • https://doi.org/10.1186/s12873-022-00739-wDOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-494717URI
  • https://gup.ub.gu.se/publication/323632URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • 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. 

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  • Danielsson, ChristianDepartment of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Dept Clin Pathol, Gothenburg, Sweden. (author)
  • Forkman, PontusDepartment of Adult Psychiatry, Mora Hospital, Mora, Sweden,Mora Hosp, Dept Adult Psychiat, Mora, Sweden. (author)
  • Karlsson, Thomas,1956Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine(Swepub:gu)xkarth (author)
  • Pettersson, LindaUppsala universitet,Institutionen för folkhälso- och vårdvetenskap(Swepub:uu)linpe840 (author)
  • Herlitz, Johan,1949-Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Univ Coll Borås, Ctr Prehosp Res Western Sweden, Borås, Sweden.(Swepub:hb)JHZ (author)
  • Lundin, StefanDepartment of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Univ Hosp, Dept Anaesthesiol & Intens Care Med, Gothenburg, Sweden. (author)
  • Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, SwedenSahlgrens Univ Hosp, Dept Anaesthesiol & Intens Care Med, Gothenburg, Sweden. (creator_code:org_t)

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  • In:BMC Emergency Medicine: Springer Science and Business Media LLC22:11471-227X

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