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学术急诊医学档案

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  3. 卷 10 编号 1 (2022): Continuous volume
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卷 10 编号 1 (2022)

一月 2022

Predicting the 28-Day Mortality of Non-Trauma Patients using REMS and RAPS; a Prognostic Accuracy Study

  • Omid Garkaz
  • Farzin Rezazadeh
  • Saeed Golfiroozi
  • Sahar Paryab
  • Sadaf Nasiri
  • Hamidreza Mehryar
  • Mousa Ghelichi-Ghojogh

学术急诊医学档案, 卷 10 编号 1 (2022), 1 一月 2022 , 第 e52 页
https://doi.org/10.22037/aaem.v10i1.1601 已出版: 2022-07-04

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摘要

Introduction: Various scoring systems have been designed for calculating the mortality risk of patients. This study evaluated the accuracy of Rapid Emergency Medicine Score (REMS) and Rapid Acute Physiology Score (RAPS) in predicting the 28-day mortality of non-trauma patients.

Methods: This prospective cross-sectional study was conducted on 1003 adult non-trauma patients, who referred to the emergency department of Imam Khomeini Hospital, Urmia, Iran, in the second half of 2018, using the census sampling. We determined the screening performance characteristics of REMS and RAPS in predicting the 28-day mortality of patients.   

Results: This study examined 1003 non-trauma patients with a mean age of 61.5±18.05 years (60.6% male). The mean REMS (8.7 ± 3.2 vs. 6.0 ± 3.6; p < 0.001) and RAPS (3.7 ± 2.8 vs. 2.7 ± 2.0; p < 0.001) scores were significantly higher in deceased cases.

Sensitivity and specificity of REMS in predicting the risk of non-trauma patients’ mortality were 85.19% (95%CI: 78.05% - 90.71%) and 78.34% (95%CI: 75.45% - 81.04%), respectively. While, the Sensitivity and specificity of RAPS in this regard were 61.39% (95%CI: 53.33% - 69.02%) and 71.12% (95%CI: 67.94% - 74.16%), respectively. The area under the receiver operating characteristic (ROC) curve of REMS and RAPS were 0.72 (95% CI: 0.68 -0.75) and 0.62 (95% CI: 0.56 - 0.65) in predicting the patients’ 28-day mortality, respectively (p = 0.001).

Conclusion: The total accuracies of REMS and RAPS in predicting the 28-day mortality of non-trauma patients were in good and poor range, respectively. The screening performance characteristics of REMS were a little better in this regard.

关键词:
  • Emergencies
  • Emergency Service, Hospital
  • Mortality
  • Clinical Decision Rules
  • Prognosis
  • pdf (English)

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Garkaz O, Rezazadeh F, Golfiroozi S, Paryab S, Nasiri S, Mehryar H, 等. Predicting the 28-Day Mortality of Non-Trauma Patients using REMS and RAPS; a Prognostic Accuracy Study . Arch Acad Emerg Med [网际网络]. 2022年7月4日 [见引于 2026年7月7日];10(1):e52. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1601
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参考

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Garkaz O, Mehryar HR, Khalkhali HR, Salari Lak S. Factors affecting the severity of traffic accident injuries; a cross-sectional study based on the Haddon matrix. Trauma Mon. 2020;25(1):52-8

Hyzy RC. ICU scoring and clinical decision making. Chest. 1995;107(6):1482-3.

Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II-A Severity of disease classification system: Reply. Crit Care Med. 1986;14(8):755-802

Nakhjavan-Shahraki B, Baikpour M, Yousefifard M, Nikseresht ZS, Abiri S, Razaz JM, et al. Rapid acute physiology score versus rapid emergency medicine score in Trauma Outcome Prediction; a comparative study. Arch. Acad. Emerg. Med. 2017;5(1).1-8

Nakhjavan-Shahraki B, Yousefifard M, Faridaalaee G, Shahsavari K, Oraii A, Hajighanbari MJ, et al. Performance of physiology scoring systems in prediction of in-hospital mortality of traumatic children: A prospective observational study. J Clin Orthop Trauma. 2017;8(2):43-8.

Imhoff BF, Thompson NJ, Hastings MA, Nazir N, Moncure M, Cannon CM. Rapid Emergency Medicine Score (REMS) in the trauma population: a retrospective study. BMJ open. 2014;4(5):e004738.

Toloui A, Neishaboori AM, Alavi SNR, Gubari MI, Khaneh AZS, Ghahfarokhi MK, et al. The Value of Physiological Scoring Criteria in Predicting the In-Hospital Mortality of Acute Patients; a Systematic Review and Meta-Analysis. Arch. Acad. Emerg. Med. 2021;9(1).e60

Hilderink MJ, Roest AA, Hermans M, Keulemans YC, Stehouwer CD, Stassen PM. Predictive accuracy and feasibility of risk stratification scores for 28-day mortality of patients with sepsis in an emergency department. Eur J Emerg Med. 2015;22(5):331-7.

Seak C-J, Yen DH-T, Ng C-J, Wong Y-C, Hsu K-H, Seak JC-Y, et al. Rapid Emergency Medicine Score: A novel prognostic tool for predicting the outcomes of adult patients with hepatic portal venous gas in the emergency department. PloS one. 2017;12(9):e0184813.

Ha DT, Dang TQ, Tran NV, Vo NY, Nguyen ND, Nguyen TV. Prognostic performance of the Rapid Emergency Medicine Score (REMS) and Worthing Physiological Scoring system (WPS) in emergency department. Int J Emerg Med. 2015;8(1):1-8.

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Bahrmann A, Benner L, Christ M, Bertsch T, Sieber CC, Katus H, et al. The Charlson Comorbidity and Barthel Index predict length of hospital stay, mortality, cardiovascular mortality and rehospitalization in unselected older patients admitted to the emergency department. Aging Clin Exp Res. 2019;31(9):1233-42.

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