Document Detail


Charlson Comorbidity Index can add prognostic information to Rapid Emergency Medicine Score as a predictor of long-term mortality.
MedLine Citation:
PMID:  16175058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate whether co-existing medical disorders, summed up in a comorbidity index, in nonsurgical patients attending the emergency department could predict short-term and long-term mortality, and whether the index could add prognostic information to the Rapid Emergency Medicine Score. METHODS: This was a prospective cohort study. In all, 885 nonsurgical patients, presenting to an adult emergency department and admitted to a medical department of a 1200-bed university hospital during 2 months, were enrolled consecutively. The Rapid Emergency Medicine Score (including blood pressure, oxygen saturation, respiratory rate, pulse rate, age and Glasgow coma scale) was calculated within 20 min in all those admitted to the emergency department. The history of coexisting disorders (Charlson Comorbidity Index) was collected from the medical records. RESULTS: In a univariate analysis, the Charlson Comorbidity Index could predict both short-term and long-term mortality in nonsurgical emergency department patients. An increase of one point in the 16-point Charlson Comorbidity Index scale was associated with a hazard ratio of 1.15 (95% CI 1.04-1.28, P<0.0001) for 7-day mortality and 1.28 (95% CI 1.23-1.33, P<0.0001) for 5-year mortality. The Rapid Emergency Medicine Score could also predict both short-term and long-term mortality (hazard ratio for an increase of one point in the 26-point Rapid Emergency Medicine Score scale was 1.33 (95% CI 1.28-1.39, P<0.0001) for 7-day mortality and 1.25 (95% CI 1.22-1.28, P<0.0001) for 5-year mortality. The Charlson Comorbidity Index could also add prognostic information to the Rapid Emergency Medicine Score as a predictor of long-term mortality, but it could not independently predict short-term (3-day, 7-day) mortality when forced into the same multivariate logistic model as the Rapid Emergency Medicine Score (hazard ratio for one point increase in the Charlson Comorbidity Index was 1.20 for 5-year mortality (95% CI 1.15-1.25, P<0.0001). CONCLUSION: Information on coexisting disorders (Charlson Comorbidity Index) can prognosticate both short-term and long-term mortality in the nonsurgical emergency department. It can also add prognostic information to the Rapid Emergency Medicine Score as a predictor of long-term mortality.
Authors:
Thomas Olsson; Andreas Terent; Lars Lind
Related Documents :
18783488 - Recommendations from the society for academic emergency medicine (saem) taskforce on wo...
2362128 - Objectives to direct the training of emergency medicine residents on off-service rotati...
19585848 - Medical emergencies in dental practice: 2. management of specific medical emergencies.
18459408 - Emergence, trapping, and seasonal abundance of adult cerambycidae (coleoptera) associat...
16061158 - Case management: entry-level practice for occupational therapists?
22633338 - Emergency department discharge prescription interventions by emergency medicine pharmac...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of emergency medicine : official journal of the European Society for Emergency Medicine     Volume:  12     ISSN:  0969-9546     ISO Abbreviation:  Eur J Emerg Med     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-21     Completed Date:  2006-02-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  220-4     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Uppsala University, Akademiska sjukhuset. thomas.olsson@jll.se
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Comorbidity*
Emergency Service, Hospital*
Emergency Treatment*
Female
Humans
Male
Mortality*
Outcome Assessment (Health Care)
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Assessment / methods
Severity of Illness Index*
Sweden / epidemiology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Ankle fractures: emergency department management...is there room for improvement?
Next Document:  Accidental intravenous administration of racemic adrenaline: two cases associated with adverse cardi...