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Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department

BACKGROUND: The Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) have been developed for predicting in-hospital mortality in nonsurgical emergency department (ED) patients. The prognostic performance of the scoring systems in independent populations has not been...

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Autores principales: Ha, Duc T, Dang, Tam Q, Tran, Ngoc V, Vo, Nhi Y, Nguyen, Nguyen D, Nguyen, Tuan V
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457731/
https://www.ncbi.nlm.nih.gov/pubmed/26069474
http://dx.doi.org/10.1186/s12245-015-0066-3
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author Ha, Duc T
Dang, Tam Q
Tran, Ngoc V
Vo, Nhi Y
Nguyen, Nguyen D
Nguyen, Tuan V
author_facet Ha, Duc T
Dang, Tam Q
Tran, Ngoc V
Vo, Nhi Y
Nguyen, Nguyen D
Nguyen, Tuan V
author_sort Ha, Duc T
collection PubMed
description BACKGROUND: The Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) have been developed for predicting in-hospital mortality in nonsurgical emergency department (ED) patients. The prognostic performance of the scoring systems in independent populations has not been clear. The aim of the study is to evaluate the prognostic accuracy of REMS and WPS systems in the estimation of 30-day mortality risk among medical patients in ED. METHODS: The study was designed as a prospective investigation, with the setting being the ED of the National Hospital of Can Tho, Vietnam. We enrolled medical patients aged 16+ years who met the study entry criteria. Clinical data were obtained as required for each scoring system. The primary outcome was mortality within 30 days since hospitalization. The association between each scoring system and mortality was assessed by the hazard ratio (HR) of the Cox’s proportional hazard model. RESULTS: The study involved 1746 patients, average age 65.9 years (SD 17). During the period of follow-up, 172 patients (9.9 %) died. The risk of 30-day mortality was increased by 30 % for each additional REMS unit (HR: 1.28; 95 % confidence interval (CI): 1.23–1.34) and by 60 % for each additional WPS unit (HR: 1.6; 95 % CI: 1.5–1.7). The AUC of the REMS was 0.71 (95 % CI: 0.67–0.76) which was significantly lower than that of the WPS (0.80; 95 % CI: 0.76–0.83). CONCLUSIONS: Both REMS and WPS have good prognostic value in the prediction of death in ED patients. The WPS appeared to have a better prognostic performance than the REMS system. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12245-015-0066-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-44577312015-06-11 Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department Ha, Duc T Dang, Tam Q Tran, Ngoc V Vo, Nhi Y Nguyen, Nguyen D Nguyen, Tuan V Int J Emerg Med Educational Advances in Emergency Medicine BACKGROUND: The Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) have been developed for predicting in-hospital mortality in nonsurgical emergency department (ED) patients. The prognostic performance of the scoring systems in independent populations has not been clear. The aim of the study is to evaluate the prognostic accuracy of REMS and WPS systems in the estimation of 30-day mortality risk among medical patients in ED. METHODS: The study was designed as a prospective investigation, with the setting being the ED of the National Hospital of Can Tho, Vietnam. We enrolled medical patients aged 16+ years who met the study entry criteria. Clinical data were obtained as required for each scoring system. The primary outcome was mortality within 30 days since hospitalization. The association between each scoring system and mortality was assessed by the hazard ratio (HR) of the Cox’s proportional hazard model. RESULTS: The study involved 1746 patients, average age 65.9 years (SD 17). During the period of follow-up, 172 patients (9.9 %) died. The risk of 30-day mortality was increased by 30 % for each additional REMS unit (HR: 1.28; 95 % confidence interval (CI): 1.23–1.34) and by 60 % for each additional WPS unit (HR: 1.6; 95 % CI: 1.5–1.7). The AUC of the REMS was 0.71 (95 % CI: 0.67–0.76) which was significantly lower than that of the WPS (0.80; 95 % CI: 0.76–0.83). CONCLUSIONS: Both REMS and WPS have good prognostic value in the prediction of death in ED patients. The WPS appeared to have a better prognostic performance than the REMS system. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12245-015-0066-3) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2015-06-04 /pmc/articles/PMC4457731/ /pubmed/26069474 http://dx.doi.org/10.1186/s12245-015-0066-3 Text en © Ha et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Educational Advances in Emergency Medicine
Ha, Duc T
Dang, Tam Q
Tran, Ngoc V
Vo, Nhi Y
Nguyen, Nguyen D
Nguyen, Tuan V
Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department
title Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department
title_full Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department
title_fullStr Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department
title_full_unstemmed Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department
title_short Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department
title_sort prognostic performance of the rapid emergency medicine score (rems) and worthing physiological scoring system (wps) in emergency department
topic Educational Advances in Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457731/
https://www.ncbi.nlm.nih.gov/pubmed/26069474
http://dx.doi.org/10.1186/s12245-015-0066-3
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