Emphysema severity index (ESI) associated with respiratory death in a large Swedish general population

Luoto, Johannes; Pihlsgård, Mats; Paoletti, Matteo; Occhipinti, Mariaelena; Wollmer, Per; Elmståhl, Sölve

doi:10.1016/j.rmed.2022.106899

Cited by 1 publication

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References 16 publications

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“…In recent years, the primary assessment scales for the prognosis of elderly patients include the Programme on Research for Integrating Services for the Maintenance of Autonomy 7 (PRISMA-7), the quick sequential organ failure assessment (qSOFA) score, the Emergency Severity Index (ESI), and the Clinical Frailty Scale (CFS). [7][8][9] However, the value of scoring systems in predicting the risk of death in elderly patients in the emergency department has rarely been reported, and their predictive performance is unclear. To clarify the predictive value of the above-mentioned scoring systems for mortality risk in elderly patients in the emergency department, we implemented the present clinical study.…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of PRISMA-7, qSOFA, ESI, and CFS for 28-Day Mortality in Elderly Patients in the Emergency Department

Hao¹,

Zhou²,

Zou³

et al. 2023

JIR

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Background To explore the predictive value of the Programme on Research for Integrating Services for the Maintenance of Autonomy 7 (PRISMA-7), quick Sequential Organ Failure Assessment (qSOFA) score, Emergency Severity Index (ESI), and Clinical Frailty Scale (CFS) on the 28-day mortality risk in emergency elderly patients. Methods A multicenter prospective observational study was conducted to select elderly patients (≥65 years old) admitted to the emergency department of three Grade-A hospitals in different regions of China from January 2020 to March 2022. Primary data were collected at the time of admission. All patients were followed up for 28 days. The primary outcome was 28-day mortality. The predictive value of four scoring systems for 28-day mortality in elderly emergency patients was assessed by receiver operating characteristic (ROC) and logistic regression analysis. Results A total of 687 elderly emergency patients were enrolled, of whom 66 (9.61%) died within 28 days. Age, ICU admission rate, PRISMA-7, qSOFA, and CFS were significantly higher in the death group than in the survival group (P < 0.05), and ESI was lower than in the survival group (P < 0.001). The AUC for CFS was the largest of the four scoring systems at 0.80. According to the Youden index, the optimal cutoff values for PRISMA-7, qSOFA, ESI, and CFS were >3.5, >0.5, <2.5, and >4.5, respectively. Logistic regression revealed that qSOFA and CFS were the primary risk factors for increased 28-day mortality in elderly emergency patients (P < 0.001). The combined predictor L (L=X1+0.50X2, X1 and X2 are qSOFA and CFS values, respectively) had an AUC of 0.86 and a cutoff value >2.75. Conclusion PRISMA-7, qSOFA, ESI, CFS, and the combined qSOFA+CFS predictor were all effective predictors of 28-day mortality risk in elderly emergency patients, with the combined qSOFA+CFS predictor having the best predictive power.

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Section: Introductionmentioning

confidence: 99%