risk assessment in the first fifteen minutes a prospective cohort study of a simple physiological scoring system in the emergency department风险评估在第一个十五分钟的前瞻性群组研究一个简单的生理评分系统在急诊室.pdfVIP

Merz et al. Critical Care 2011, 15:R25 /content/15/1/R25 RESEARCH Open Access Risk assessment in the first fifteen minutes: a prospective cohort study of a simple physiological scoring system in the emergency department 1* 1 1 1 1 2 1 Tobias M Merz , Reto Etter , Ludger Mende , Daniel Barthelmes , Jan Wiegand , Luca Martinolli , Jukka Takala Abstract Introduction: The survival of patients admitted to an emergency department is determined by the severity of acute illness and the quality of care provided. The high number and the wide spectrum of severity of illness of admitted patients make an immediate assessment of all patients unrealistic. The aim of this study is to evaluate a scoring system based on readily available physiological parameters immediately after admission to an emergency department (ED) for the purpose of identification of at-risk patients. Methods: This prospective observational cohort study includes 4,388 consecutive adult patients admitted via the ED of a 960-bed tertiary referral hospital over a period of six months. Occurrence of each of seven potential vital sign abnormalities (threat to airway, abnormal respiratory rate, oxygen saturation, systolic blood pressure, heart rate, low Glasgow Coma Scale and seizures) was collected and added up to generate the vital sign score (VSS). VSSinitial was defined as the VSS in the first 15 minutes after admission, VSSmax as the maximum VSS throughout the stay in ED. Occurrence of single vital sign abnormalities in the first 15 minutes and VSSinitial and VSSmax were evaluated as potential predictors of hospital mortality. Results: Logistic regression analysis identified all evaluated single vital sign abnormalities e