Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso

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 metaboli...

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Autores principales:	Cofré,Claudia, Cavada,Gabriel, Maquilón,César, Daza,Paula, Vargas,Ángel, Vukusich,Antonio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2017
Materias:	Patients Rooms Risk assessment Hospital Rapid Response Team Emergencies Medical Services
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000200002
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spelling	oai:scielo:S0034-988720170002000022017-05-02Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingresoCofré,ClaudiaCavada,GabrielMaquilón,CésarDaza,PaulaVargas,ÁngelVukusich,Antonio Patients Rooms Risk assessment Hospital Rapid Response Team Emergencies Medical Services 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 and Methods: 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.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.2 20172017-02-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000200002es10.4067/S0034-98872017000200002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Patients Rooms Risk assessment Hospital Rapid Response Team Emergencies Medical Services
spellingShingle	Patients Rooms Risk assessment Hospital Rapid Response Team Emergencies Medical Services Cofré,Claudia Cavada,Gabriel Maquilón,César Daza,Paula Vargas,Ángel Vukusich,Antonio Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso
description	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 and Methods: 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.
author	Cofré,Claudia Cavada,Gabriel Maquilón,César Daza,Paula Vargas,Ángel Vukusich,Antonio
author_facet	Cofré,Claudia Cavada,Gabriel Maquilón,César Daza,Paula Vargas,Ángel Vukusich,Antonio
author_sort	Cofré,Claudia
title	Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso
title_short	Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso
title_full	Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso
title_fullStr	Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso
title_full_unstemmed	Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso
title_sort	puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso
publisher	Sociedad Médica de Santiago
publishDate	2017
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000200002
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Puntaje predictivo de emergencias médicas en un servicio médico quirúrgico, usando variables clínicas y los diagnósticos de ingreso

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