2024-03-28T14:24:58Zhttps://uvadoc.uva.es/oai/requestoai:uvadoc.uva.es:10324/480972021-08-26T20:47:00Zcom_10324_1179com_10324_931com_10324_894col_10324_1306
Time for a prehospital-modified sequential organ failure assessment score: An ambulance–Based cohort study
Martín Rodríguez, Francisco
Sanz García, Ancor
Pozo Vegas, Carlos del
Ortega, Guillermo José
Castro Villamor, Miguel Ángel
López Izquierdo, Raúl
Short-term mortality
Mortalidad a corto plazo
Emergency medical services
Servicio de emergencias
Prehospital care
Cuidados prehospitalarios
Producción Científica
Background: To adapt the Sequential Organ Failure Assessment (SOFA) score to fit the prehospital care needs; to do that, the SOFA was modified by replacing platelets and bilirubin, by lactate, and tested this modified SOFA (mSOFA) score in its prognostic capacity to assess the mortality-risk at 2 days since the first Emergency Medical Service (EMS) contact.
Methods: Prospective, multicentric, EMS-delivery, ambulance-based, pragmatic cohort study of adults with acute diseases, referred to two tertiary care hospitals (Spain), between January 1st and December 31st, 2020. The discriminative power of the predictive variable was assessed through a prediction model trained using the derivation cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) on the validation cohort.
Results: A total of 1114 participants comprised two separated cohorts recruited from 15 ambulance stations. The 2-day mortality rate (from any cause) was 5.9% (66 cases). The predictive validity of the mSOFA score was assessed by the calculation of the AUC of ROC in the validation cohort, resulting in an AUC of 0.946 (95% CI, 0.913–0.978, p < .001), with a positive likelihood ratio was 23.3 (95% CI, 0.32–46.2).
Conclusions: Scoring systems are now a reality in prehospital care, and the mSOFA score assesses multiorgan dysfunction in a simple and agile manner either bedside or en route. Patients with acute disease and an mSOFA score greater than 6 points transferred with high priority by EMS represent a high early mortality group.
Gerencia Regional de Salud de Castilla y León (grants GRS 1678/A/18 and GRS 1903/A/19)
2021-08-26T08:21:21Z
2021-08-26T08:21:21Z
2021
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
The American Journal of Emergency Medicine, 2021, vol. 49. p. 331-337
0735-6757
https://uvadoc.uva.es/handle/10324/48097
10.1016/j.ajem.2021.06.042
eng
https://www.sciencedirect.com/science/article/pii/S073567572100526X?via%3Dihub
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by-nc-nd/4.0/
© 2021 The Authors
application/pdf
Elsevier
https://uvadoc.uva.es/bitstream/10324/48097/4/Time-for-prehospital-modified-sequential.pdf.jpg
Hispana
TEXT
http://creativecommons.org/licenses/by-nc-nd/4.0/
UVaDOC. Repositorio Documental de la Universidad de Valladolid
https://uvadoc.uva.es/handle/10324/48097