Lucke et al reported 2 models for evaluating an adult in the Emergency Department. One model predicts hospital admission for an older adult less than 70 years of age. 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: 18 to 69 years of age
Outcome: hospital admission
Parameters:
(1) age in years
(2) sex
(3) time to triage
(4) reason for coming to ED
(5) chief complaint
(6) type of specialist
(7) revisit to ED
(8) blood specimen drawn (phlebotomy)
(9) oxygen saturation in percent
(10) systolic blood pressure
(11) body temperature in °C
(12) heart rate in beats per minute
(13) respiratory rate in breaths per minute
|
Parameter |
Finding |
Points |
|
age in years |
|
0.220 * (age) / 10 |
|
sex |
female |
0 |
|
|
male |
0.225 |
|
time to triage |
< 10 minutes |
1.292 |
|
|
10 to 59 minutes |
0.798 |
|
|
>= 60 minutes |
0 |
|
reason for coming |
self-referral |
0.194 |
|
|
physician referral |
0 |
|
|
ambulance |
0.664 |
|
chief complaint |
major trauma |
0.273 |
|
|
minor trauma |
0 |
|
|
chest pain |
-1.282 |
|
|
breathlessness |
-0.238 |
|
|
syncope |
-0.305 |
|
|
psychiatric complaint |
0.391 |
|
|
malaise |
0.269 |
|
|
abdominal pain |
0.294 |
|
|
other complaint |
0.122 |
|
type of specialist |
surgery |
0 |
|
|
medicine |
0.155 |
|
revisit to ED |
no |
0 |
|
|
yes |
0.453 |
|
blood drawn |
no |
0 |
|
|
yes |
1.567 |
|
oxygen saturation |
>= 95% |
0 |
|
|
91 to 94% |
0.576 |
|
|
<= 90% |
0.585 |
|
|
missing |
0.103 |
|
systolic blood pressure |
>= 200 mm Hg |
0.277 |
|
|
101 to 199 mm Hg |
0 |
|
|
<= 100 mm Hg |
0.674 |
|
|
missing |
-0.558 |
|
body temperature |
<= 35°C |
0.619 |
|
|
35.1 to 38.4°C |
0 |
|
|
>= 38.5°C |
1.205 |
|
|
missing |
-0.165 |
|
heart rate |
<= 50 beats per minute |
-0.395 |
|
|
51 to 100 beats per minute |
0 |
|
|
101 to 110 beats per min |
0.481 |
|
|
111 to 129 beats per min |
0.450 |
|
|
>= 130 beats per minute |
0.943 |
|
|
missing |
0.071 |
|
respiratory rate |
<= 8 breaths per minute |
-0.290 |
|
|
9 to 14 breaths per min |
0 |
|
|
15 to 20 breaths per min |
-0.064 |
|
|
21 to 29 breaths per min |
0.256 |
|
|
>= 30 breaths per min |
1.380 |
|
|
missing |
0.047 |
value of X =
= SUM(points for all parameters) - 4.572
probability of admission =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve 0.86.
