Level of Vital and Laboratory Values on Arrival, and Increased Risk of 7-day Mortality Among Adult Patients in the Emergency Department: a Population-based Cohort Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2020 Nov 18

PMID 33203628

Citations 3

Authors

Peter Bank Pedersen

Daniel Pilsgaard Henriksen

Mikkel Brabrand

Annmarie Touborg Lassen

Affiliations

Soon will be listed here.

Abstract

Objectives: The aim of the study was to provide evidence for, at which vital and laboratory values, increased risk of 7-day mortality in acute adult patients on arrival to an emergency department (ED).

Design: A population-based cohort study.

Setting: ED at Odense University Hospital, Denmark.

Participants: All patients ≥18 years with a first-time contact within the study period, 1 April 2012 to 31 March 2015.

Primary And Secondary Outcome Measures: Primary outcome was 7-day all-cause mortality.Variables were first recorded vital and laboratory values included in risk stratification scores; respiratory frequency, blood pressure, heart rate, Glasgow Coma Scale, temperature, saturation, creatinine, PaO, platelet count and bilirubin. The association between values and mortality was described using a restricted cubic spline. A predefined 7-day mortality of 2.5% was chosen as a relevant threshold.

Results: We included 40 423 patients, 52.5% women, median age 57 (IQR 38-74) years and 7-day mortality 2.8%. Seven-day mortality of 2.5% had thresholds of respiratory frequency <12 and >18/min, systolic blood pressure <112 and >192 mm Hg, heart rate <54 and >102 beats/min, temperature <36.0°C and >39.8°C, saturation <97%, Glasgow Coma Scale score <15, creatinine <41 and >98 µmol/L for PaO <9.9 and >12.3 kPa, platelet count <165 and >327×10/L and bilirubin >12 µmol/L.

Conclusion: Vital values on arrival, outside the normal ranges for the measures, are indicative of increased risk of short-term mortality, and most of the value thresholds are included in the lowest urgency level in triage and risk stratification scoring systems.

Citing Articles

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Loisa E, Kallonen A, Hoppu S, Tirkkonen J BMJ Open. 2022; 12(4):e055752.

PMID: 35473725 PMC: 9045111. DOI: 10.1136/bmjopen-2021-055752.

Age-adjusted interpretation of biomarkers of renal function and homeostasis, inflammation, and circulation in Emergency Department patients.

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Organ failure, aetiology and 7-day all-cause mortality among acute adult patients on arrival to an emergency department: a hospital-based cohort study.

Pedersen P, Henriksen D, Brabrand M, Lassen A Eur J Emerg Med. 2021; 28(6):448-455.

PMID: 34115711 PMC: 8549456. DOI: 10.1097/MEJ.0000000000000841.

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