RT info:eu-repo/semantics/article
T1 Time for a prehospital-modified sequential organ failure assessment score: An ambulance–Based cohort study
A1 Martín Rodríguez, Francisco
A1 Sanz García, Ancor
A1 Pozo Vegas, Carlos del
A1 Ortega, Guillermo José
A1 Castro Villamor, Miguel Ángel
A1 López Izquierdo, Raúl
K1 Short-term mortality
K1 Mortalidad a corto plazo
K1 Emergency medical services
K1 Servicio de emergencias
K1 Prehospital care
K1 Cuidados prehospitalarios
AB 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.
PB Elsevier
SN 0735-6757
YR 2021
FD 2021
LK https://uvadoc.uva.es/handle/10324/48097
UL https://uvadoc.uva.es/handle/10324/48097
LA eng
NO The American Journal of Emergency Medicine, 2021, vol. 49. p. 331-337
NO Producción Científica
DS UVaDOC
RD 23-nov-2024