https://scholars.lib.ntu.edu.tw/handle/123456789/616110
標題: | External validation of a triage tool for predicting cardiac arrest in the emergency department | 作者: | Sun, Jen-Tang Chang, Chih-Chun TSUNG-CHIEN LU Lin, Jasper Chia-Cheng CHIH-HUNG WANG CHENG-CHUNG FANG CHIEN-HUA HUANG WEN-JONE CHEN CHU-LIN TSAI |
關鍵字: | EARLY WARNING SCORE | 公開日期: | 2022 | 出版社: | NATURE PORTFOLIO | 卷: | 12 | 期: | 1 | 來源出版物: | Scientific reports | 摘要: | Early recognition and prevention comprise the first ring of the Chain of Survival for in-hospital cardiac arrest (IHCA). We previously developed and internally validated an emergency department (ED) triage tool, Emergency Department In-hospital Cardiac Arrest Score (EDICAS), for predicting ED-based IHCA. We aimed to externally validate this novel tool in another ED population. This retrospective cohort study used electronic clinical warehouse data from a tertiary medical center with approximately 130,000 ED visits per year. We retrieved data from 268,208 ED visits over a 2-year period. We selected one ED visit per person and excluded out-of-hospital cardiac arrest or children. Patient demographics and computerized triage information were retrieved, and the EDICAS was calculated to predict the ED-based IHCA. A total of 145,557 adult ED patients were included. Of them, 240 (0.16%) developed IHCA. The EDICAS showed excellent discrimination with an area under the receiver operating characteristic (AUROC) of 0.88. The AUROC of the EDICAS outperformed those of other early warning scores (0.80 for Modified Early Warning Score [MEWS] and 0.83 for Rapid Emergency Medicine Score [REMS]) in the same ED population. An EDICAS of 6 or above (i.e., high-risk patients) corresponded to a sensitivity of 33%, a specificity of 97%, and a positive likelihood ratio of 12.2. In conclusion, we externally validated a tool for predicting imminent IHCA in the ED and demonstrated its superior performance over other early warning scores. The real-world impact of the EDICAS warning system with appropriate interventions would require a future prospective study. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/616110 | ISSN: | 2045-2322 | DOI: | 10.1038/s41598-022-12781-6 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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