RT info:eu-repo/semantics/article
T1 Derivation and validation of a blood biomarker score for 2-day mortality prediction from prehospital care: a multicenter, cohort, EMS-based study
A1 Martín Rodríguez, Francisco
A1 Vaquerizo Villar, Fernando
A1 López Izquierdo, Raúl
A1 Castro Villamor, Miguel Ángel
A1 Sanz García, Ancor
A1 Pozo Vegas, Carlos del
A1 Hornero Sánchez, Roberto
K1 2-day mortality
K1 Blood biomarker score
K1 Creatinine
K1 Emergency medical services (EMS)
K1 Lactate
K1 Partial pressure of carbon dioxide (pCO2)
K1 32 Ciencias Médicas
AB Identifying potentially life-threatening diseases is a key challenge for emergency medical services. This study aims at examining the role of different prehospital biomarkers from point-of-care testing to derive and validate a score to detect 2-day in-hospital mortality. We conducted a prospective, observational, prehospital, ongoing, and derivation—validation study in three Spanish provinces, in adults evacuated by ambulance and admitted to the emergency department. A total of 23 ambulance-based biomarkers were collected from each patient. A biomarker score based on logistic regression was fitted to predict 2-day mortality from an optimum subset of variables from prehospital blood analysis, obtained through an automated feature selection stage. 2806 cases were analyzed, with a median age of 68 (interquartile range 51–81), 42.3% of women, and a 2-day mortality rate of 5.5% (154 non-survivors). The blood biomarker score was constituted by the partial pressure of carbon dioxide, lactate, and creatinine. The score fitted with logistic regression using these biomarkers reached a high performance to predict 2-day mortality, with an AUC of 0.933 (95% CI 0.841–0.973). The following risk levels for 2-day mortality were identified from the score: low risk (score < 1), where only 8.2% of non-survivors were assigned to; medium risk (1 ≤ score < 4); and high risk (score ≥ 4), where the 2-day mortality rate was 57.6%. The novel blood biomarker score provides an excellent association with 2-day in-hospital mortality, as well as real-time feedback on the metabolic-respiratory patient status. Thus, this score can help in the decision-making process at critical moments in life-threatening situations.
PB Springer
SN 1828-0447
YR 2023
FD 2023
LK https://uvadoc.uva.es/handle/10324/59470
UL https://uvadoc.uva.es/handle/10324/59470
LA eng
NO Internal and Emergency Medicine, 2023.
NO Producción Científica
DS UVaDOC
RD 15-ene-2025