Lucke et al reported 2 models for evaluating an adult in the Emergency Department. One model predicts hospital admission for an older adult 70 years of age or older. The authors are from Leiden University Medical Center, Medical Center Haaglanden-Bronovo and the Institute for Evidence-Based Medicine in Old Age in The Netherlands.
Patient selection: >= 70 years of age
Outcome: hospital admission
Parameters:
(1) time to triage
(2) reason for coming to ED
(3) chief complaint
(4) revisit to ED
(5) blood specimen drawn (phlebotomy)
(6) oxygen saturation in percent
(7) systolic blood pressure
(8) body temperature in °C
(9) respiratory rate in breaths per minute
Parameter
Finding
Points
time to triage
< 10 minutes
1.148
10 to 59 minutes
0.541
>= 60 minutes
0
reason for coming
self-referral
0.086
physician referral
0
ambulance
0.337
chief complaint
major trauma
-0.103
minor trauma
0
chest pain
-1.640
breathlessness
-0.829
syncope
-0.659
psychiatric complaint
0.258
malaise
0.236
abdominal pain
0.102
other complaint
0.208
revisit to ED
no
0
yes
0.663
blood drawn
no
0
yes
2.010
oxygen saturation
>= 95%
0
91 to 94%
0.483
<= 90%
1.449
missing
0.128
systolic blood pressure
>= 200 mm Hg
-0.300
101 to 199 mm Hg
0
<= 100 mm Hg
0.511
missing
-0.655
body temperature
<= 35°C
-0.037
35.1 to 38.4°C
0
>= 38.5°C
1.232
missing
-0.071
respiratory rate
<= 8 breaths per minute
0.861
9 to 14 breaths per min
0
15 to 20 breaths per min
0.037
21 to 29 breaths per min
0.555
>= 30 breaths per min
1.483
missing
-0.014
value of X =
= SUM(points for all parameters) - 2.623
probability of admission =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve 0.77.
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