Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso / A score to predict medical emergencies in hospitalized patients
Rev. méd. Chile
; 145(2): 156-163, feb. 2017. graf, tab
Article
em Es
| LILACS
| ID: biblio-845519
Biblioteca responsável:
CL1.1
ABSTRACT
Background:
The medical alert system (MAS) was created for the timely handling of clinical decompensations, experienced by patients hospitalized at the Medical Surgical Service (MSS) in a private clinic. It is activated by the nurse when hemodynamic, respiratory, neurological, infectious or metabolic alterations appear, when a patient falls or complains of pain. A physician assesses the patient and decides further therapy.Aim:
To analyze the clinical and demographic characteristics of patients who activated or not the MAS and develop a score to identify patients who will potentially activate MAS. Material andMethods:
Data from 13,933 patients discharged from the clinic in a period of one year was analyzed.Results:
MAS was activated by 472 patients (3.4%). Twenty two of these patients died during hospital stay compared to 68 patients who did not activate the alert (0.5%, p < 0.01). The predictive score developed considered age, diagnosis (based on the tenth international classification of diseases) and whether the patient was medical or surgical. The score ranges from 0 to 9 and a cutoff ≥ 6 provides a sensitivity and specificity of 37 and 81% respectively and a positive likelihood ratio (LR+) of 1.9 to predict the activation of MAS. The same cutoff value predicts death with a sensitivity and specificity of 80% and a negative predictive value of 99.8%.Conclusions:
This score may be useful to identify hospitalized patients who may have complications during their hospital stay.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Triagem
/
Sistemas de Apoio a Decisões Clínicas
/
Serviço Hospitalar de Emergência
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
America do sul
/
Chile
Idioma:
Es
Revista:
Rev. méd. Chile
Assunto da revista:
MEDICINA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
Chile