Level of vital and laboratory values on arrival, and increased risk of 7-day mortality among adult patients in the emergency department: a population-based cohort study
Objectives The aim of the study was to provide evidence for, at which vital and laboratory values, increased risk of 7-day mortality in acute adult patients on arrival to an emergency department (ED).Design A population-based cohort study.Setting ED at Odense University Hospital, Denmark.Participant...
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e038516.full |
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| author | Annmarie Touborg Lassen Peter Bank Pedersen Daniel Pilsgaard Henriksen Mikkel Brabrand |
| author_facet | Annmarie Touborg Lassen Peter Bank Pedersen Daniel Pilsgaard Henriksen Mikkel Brabrand |
| author_sort | Annmarie Touborg Lassen |
| collection | DOAJ |
| description | Objectives The aim of the study was to provide evidence for, at which vital and laboratory values, increased risk of 7-day mortality in acute adult patients on arrival to an emergency department (ED).Design A population-based cohort study.Setting ED at Odense University Hospital, Denmark.Participants All patients ≥18 years with a first-time contact within the study period, 1 April 2012 to 31 March 2015.Primary and secondary outcome measures Primary outcome was 7-day all-cause mortality.Variables were first recorded vital and laboratory values included in risk stratification scores; respiratory frequency, blood pressure, heart rate, Glasgow Coma Scale, temperature, saturation, creatinine, PaO2, platelet count and bilirubin. The association between values and mortality was described using a restricted cubic spline. A predefined 7-day mortality of 2.5% was chosen as a relevant threshold.Results We included 40 423 patients, 52.5% women, median age 57 (IQR 38–74) years and 7-day mortality 2.8%. Seven-day mortality of 2.5% had thresholds of respiratory frequency <12 and >18/min, systolic blood pressure <112 and >192 mm Hg, heart rate <54 and >102 beats/min, temperature <36.0°C and >39.8°C, saturation <97%, Glasgow Coma Scale score <15, creatinine <41 and >98 µmol/L for PaO2 <9.9 and >12.3 kPa, platelet count <165 and >327×109/L and bilirubin >12 µmol/L.Conclusion Vital values on arrival, outside the normal ranges for the measures, are indicative of increased risk of short-term mortality, and most of the value thresholds are included in the lowest urgency level in triage and risk stratification scoring systems. |
| format | Article |
| id | doaj-art-a5392594ad43446cbe6ec626276e553d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a5392594ad43446cbe6ec626276e553d2024-11-26T08:55:11ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-038516Level of vital and laboratory values on arrival, and increased risk of 7-day mortality among adult patients in the emergency department: a population-based cohort studyAnnmarie Touborg Lassen0Peter Bank Pedersen1Daniel Pilsgaard Henriksen2Mikkel Brabrand3Department of Clinical Research, University of Southern Denmark, Odense, DenmarkDepartment of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Pharmacology, Odense University Hospital, Odense, DenmarkDepartment of Emergency Medicine, Odense University Hospital, Odense, DenmarkObjectives The aim of the study was to provide evidence for, at which vital and laboratory values, increased risk of 7-day mortality in acute adult patients on arrival to an emergency department (ED).Design A population-based cohort study.Setting ED at Odense University Hospital, Denmark.Participants All patients ≥18 years with a first-time contact within the study period, 1 April 2012 to 31 March 2015.Primary and secondary outcome measures Primary outcome was 7-day all-cause mortality.Variables were first recorded vital and laboratory values included in risk stratification scores; respiratory frequency, blood pressure, heart rate, Glasgow Coma Scale, temperature, saturation, creatinine, PaO2, platelet count and bilirubin. The association between values and mortality was described using a restricted cubic spline. A predefined 7-day mortality of 2.5% was chosen as a relevant threshold.Results We included 40 423 patients, 52.5% women, median age 57 (IQR 38–74) years and 7-day mortality 2.8%. Seven-day mortality of 2.5% had thresholds of respiratory frequency <12 and >18/min, systolic blood pressure <112 and >192 mm Hg, heart rate <54 and >102 beats/min, temperature <36.0°C and >39.8°C, saturation <97%, Glasgow Coma Scale score <15, creatinine <41 and >98 µmol/L for PaO2 <9.9 and >12.3 kPa, platelet count <165 and >327×109/L and bilirubin >12 µmol/L.Conclusion Vital values on arrival, outside the normal ranges for the measures, are indicative of increased risk of short-term mortality, and most of the value thresholds are included in the lowest urgency level in triage and risk stratification scoring systems.https://bmjopen.bmj.com/content/10/11/e038516.full |
| spellingShingle | Annmarie Touborg Lassen Peter Bank Pedersen Daniel Pilsgaard Henriksen Mikkel Brabrand Level of vital and laboratory values on arrival, and increased risk of 7-day mortality among adult patients in the emergency department: a population-based cohort study BMJ Open |
| title | Level of vital and laboratory values on arrival, and increased risk of 7-day mortality among adult patients in the emergency department: a population-based cohort study |
| title_full | Level of vital and laboratory values on arrival, and increased risk of 7-day mortality among adult patients in the emergency department: a population-based cohort study |
| title_fullStr | Level of vital and laboratory values on arrival, and increased risk of 7-day mortality among adult patients in the emergency department: a population-based cohort study |
| title_full_unstemmed | Level of vital and laboratory values on arrival, and increased risk of 7-day mortality among adult patients in the emergency department: a population-based cohort study |
| title_short | Level of vital and laboratory values on arrival, and increased risk of 7-day mortality among adult patients in the emergency department: a population-based cohort study |
| title_sort | level of vital and laboratory values on arrival and increased risk of 7 day mortality among adult patients in the emergency department a population based cohort study |
| url | https://bmjopen.bmj.com/content/10/11/e038516.full |
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