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Modified Rapid Emergency Medicine Score‐Lactate (mREMS‐L) performance to screen non‐anticipated 30‐day‐related‐mortality in emergency department
Background The aim of this study was to compare the ability to predict 30‐day in‐hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS‐L). Methods A prospective, multicentric, emergen...
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| Published in: | European journal of clinical investigation 2023-08, Vol.53 (8), p.e13994-n/a |
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| container_start_page | e13994 |
| container_title | European journal of clinical investigation |
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| creator | Donoso Calero, M Isabel Laura Mordillo‐Mateos José L Martín‐Conty Begoña Polonio‐López Ángel López‐González Carlos Durantez‐Fernández Viñuela, Antonio Marta Rodríguez Hernández Alicia Mohedano‐Moriano Raúl López‐Izquierdo Soto, Cristina Jorge Francisco Martín‐Rodríguez |
| description | Background
The aim of this study was to compare the ability to predict 30‐day in‐hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS‐L).
Methods
A prospective, multicentric, emergency department delivery, pragmatic study was conducted. To determine the predictive capacity of the scales, lactate was measured and the mREMS and mREMS‐L were calculated in adult patients (aged>18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon between 1 January 2020 and 31 December 2021. The area under the receiver operating characteristic (ROC) curve of each of the scales was calculated in terms of mortality for 30 days.
Results
A total of 5371 participants were included, and the in‐hospital mortality rate at 30 days was of 11.4% (615 cases). The best cut‐off point determined in the mREMS was 7.0 points (sensitivity of 67% and specificity of 84%), and for lactate, the cut‐off point was 1.4 mmol/L (sensitivity of 88% and specificity of 67%). Finally, the combined mREMS‐L showed a cut‐off point of 7.9 (sensitivity of 83% and a specificity of 83%). The area under the ROC curve of the mREMS, lactate and mREMS‐L for 30‐day mortality was 0.851, 0.853, and 0.903, respectively (p |
| doi_str_mv | 10.1111/eci.13994 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2793990565</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2840105444</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3484-1086e92696e4c3f456f8416d3aa7c62092300cec59e2d1de36eb55796e7884093</originalsourceid><addsrcrecordid>eNp1kc9uFCEcx4nR2LV68AUMiZf2MC3_hhmOZrNqk92YtHomFH5jaGZgBDbN3HwEH8Cn80lk3dqDiRzglx8fPhC-CL2m5ILWcQnWX1CulHiCVpTLtmFcsqdoRQgVDVMdO0Evcr4jhPSUs-fohHe1poys0M9ddH7w4PC1mb3DmwnSVwh2wTtw3voA-MbGBL--_9gaW0wBfDZdb3Y3h8Y5niENMU0mWMAl4mwTQMAhhrptQqmCuR5xmJPacGapc4Lx0KrVFFMxoy8L9gHD48UOZpPKBKG8RM8GM2Z49bCeoi_vN5_XH5vtpw9X63fbxnLRi4aSXoJiUkkQlg-ilUMvqHTcmM5KRhTjhFiwrQLmqAMu4bZtu4p3fS-I4qfo7OidU_y2h1z05LOFcTQB4j5r1qn6u6SVbUXf_oPexX0K9XWaVRclrRCiUudHyqaYc4JBz8lPJi2aEn2ITNfI9J_IKvvmwbi_ncA9kn8zqsDlEbj3Iyz_N-nN-uqo_A0CL6XK</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2840105444</pqid></control><display><type>article</type><title>Modified Rapid Emergency Medicine Score‐Lactate (mREMS‐L) performance to screen non‐anticipated 30‐day‐related‐mortality in emergency department</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Donoso Calero, M Isabel ; Laura Mordillo‐Mateos ; José L Martín‐Conty ; Begoña Polonio‐López ; Ángel López‐González ; Carlos Durantez‐Fernández ; Viñuela, Antonio ; Marta Rodríguez Hernández ; Alicia Mohedano‐Moriano ; Raúl López‐Izquierdo ; Soto, Cristina Jorge ; Francisco Martín‐Rodríguez</creator><creatorcontrib>Donoso Calero, M Isabel ; Laura Mordillo‐Mateos ; José L Martín‐Conty ; Begoña Polonio‐López ; Ángel López‐González ; Carlos Durantez‐Fernández ; Viñuela, Antonio ; Marta Rodríguez Hernández ; Alicia Mohedano‐Moriano ; Raúl López‐Izquierdo ; Soto, Cristina Jorge ; Francisco Martín‐Rodríguez</creatorcontrib><description>Background
The aim of this study was to compare the ability to predict 30‐day in‐hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS‐L).
Methods
A prospective, multicentric, emergency department delivery, pragmatic study was conducted. To determine the predictive capacity of the scales, lactate was measured and the mREMS and mREMS‐L were calculated in adult patients (aged>18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon between 1 January 2020 and 31 December 2021. The area under the receiver operating characteristic (ROC) curve of each of the scales was calculated in terms of mortality for 30 days.
Results
A total of 5371 participants were included, and the in‐hospital mortality rate at 30 days was of 11.4% (615 cases). The best cut‐off point determined in the mREMS was 7.0 points (sensitivity of 67% and specificity of 84%), and for lactate, the cut‐off point was 1.4 mmol/L (sensitivity of 88% and specificity of 67%). Finally, the combined mREMS‐L showed a cut‐off point of 7.9 (sensitivity of 83% and a specificity of 83%). The area under the ROC curve of the mREMS, lactate and mREMS‐L for 30‐day mortality was 0.851, 0.853, and 0.903, respectively (p < 0.001 in all cases).
Conclusions
The new score generated, mREMS‐L, obtained better statistical results than its components (mREMS and lactate) separately.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/eci.13994</identifier><identifier>PMID: 37000120</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>early death ; emergency department ; Emergency medical care ; Emergency medical services ; Emergency vehicles ; Hospitals ; lactate ; Lactic acid ; Mathematical analysis ; modified Rapid Emergency Medicine Score ; Mortality ; mREMS‐L ; Sensitivity</subject><ispartof>European journal of clinical investigation, 2023-08, Vol.53 (8), p.e13994-n/a</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.</rights><rights>2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3484-1086e92696e4c3f456f8416d3aa7c62092300cec59e2d1de36eb55796e7884093</cites><orcidid>0000-0003-4306-1607 ; 0000-0001-8579-2323</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37000120$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Donoso Calero, M Isabel</creatorcontrib><creatorcontrib>Laura Mordillo‐Mateos</creatorcontrib><creatorcontrib>José L Martín‐Conty</creatorcontrib><creatorcontrib>Begoña Polonio‐López</creatorcontrib><creatorcontrib>Ángel López‐González</creatorcontrib><creatorcontrib>Carlos Durantez‐Fernández</creatorcontrib><creatorcontrib>Viñuela, Antonio</creatorcontrib><creatorcontrib>Marta Rodríguez Hernández</creatorcontrib><creatorcontrib>Alicia Mohedano‐Moriano</creatorcontrib><creatorcontrib>Raúl López‐Izquierdo</creatorcontrib><creatorcontrib>Soto, Cristina Jorge</creatorcontrib><creatorcontrib>Francisco Martín‐Rodríguez</creatorcontrib><title>Modified Rapid Emergency Medicine Score‐Lactate (mREMS‐L) performance to screen non‐anticipated 30‐day‐related‐mortality in emergency department</title><title>European journal of clinical investigation</title><addtitle>Eur J Clin Invest</addtitle><description>Background
The aim of this study was to compare the ability to predict 30‐day in‐hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS‐L).
Methods
A prospective, multicentric, emergency department delivery, pragmatic study was conducted. To determine the predictive capacity of the scales, lactate was measured and the mREMS and mREMS‐L were calculated in adult patients (aged>18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon between 1 January 2020 and 31 December 2021. The area under the receiver operating characteristic (ROC) curve of each of the scales was calculated in terms of mortality for 30 days.
Results
A total of 5371 participants were included, and the in‐hospital mortality rate at 30 days was of 11.4% (615 cases). The best cut‐off point determined in the mREMS was 7.0 points (sensitivity of 67% and specificity of 84%), and for lactate, the cut‐off point was 1.4 mmol/L (sensitivity of 88% and specificity of 67%). Finally, the combined mREMS‐L showed a cut‐off point of 7.9 (sensitivity of 83% and a specificity of 83%). The area under the ROC curve of the mREMS, lactate and mREMS‐L for 30‐day mortality was 0.851, 0.853, and 0.903, respectively (p < 0.001 in all cases).
Conclusions
The new score generated, mREMS‐L, obtained better statistical results than its components (mREMS and lactate) separately.</description><subject>early death</subject><subject>emergency department</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency vehicles</subject><subject>Hospitals</subject><subject>lactate</subject><subject>Lactic acid</subject><subject>Mathematical analysis</subject><subject>modified Rapid Emergency Medicine Score</subject><subject>Mortality</subject><subject>mREMS‐L</subject><subject>Sensitivity</subject><issn>0014-2972</issn><issn>1365-2362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kc9uFCEcx4nR2LV68AUMiZf2MC3_hhmOZrNqk92YtHomFH5jaGZgBDbN3HwEH8Cn80lk3dqDiRzglx8fPhC-CL2m5ILWcQnWX1CulHiCVpTLtmFcsqdoRQgVDVMdO0Evcr4jhPSUs-fohHe1poys0M9ddH7w4PC1mb3DmwnSVwh2wTtw3voA-MbGBL--_9gaW0wBfDZdb3Y3h8Y5niENMU0mWMAl4mwTQMAhhrptQqmCuR5xmJPacGapc4Lx0KrVFFMxoy8L9gHD48UOZpPKBKG8RM8GM2Z49bCeoi_vN5_XH5vtpw9X63fbxnLRi4aSXoJiUkkQlg-ilUMvqHTcmM5KRhTjhFiwrQLmqAMu4bZtu4p3fS-I4qfo7OidU_y2h1z05LOFcTQB4j5r1qn6u6SVbUXf_oPexX0K9XWaVRclrRCiUudHyqaYc4JBz8lPJi2aEn2ITNfI9J_IKvvmwbi_ncA9kn8zqsDlEbj3Iyz_N-nN-uqo_A0CL6XK</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Donoso Calero, M Isabel</creator><creator>Laura Mordillo‐Mateos</creator><creator>José L Martín‐Conty</creator><creator>Begoña Polonio‐López</creator><creator>Ángel López‐González</creator><creator>Carlos Durantez‐Fernández</creator><creator>Viñuela, Antonio</creator><creator>Marta Rodríguez Hernández</creator><creator>Alicia Mohedano‐Moriano</creator><creator>Raúl López‐Izquierdo</creator><creator>Soto, Cristina Jorge</creator><creator>Francisco Martín‐Rodríguez</creator><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4306-1607</orcidid><orcidid>https://orcid.org/0000-0001-8579-2323</orcidid></search><sort><creationdate>202308</creationdate><title>Modified Rapid Emergency Medicine Score‐Lactate (mREMS‐L) performance to screen non‐anticipated 30‐day‐related‐mortality in emergency department</title><author>Donoso Calero, M Isabel ; Laura Mordillo‐Mateos ; José L Martín‐Conty ; Begoña Polonio‐López ; Ángel López‐González ; Carlos Durantez‐Fernández ; Viñuela, Antonio ; Marta Rodríguez Hernández ; Alicia Mohedano‐Moriano ; Raúl López‐Izquierdo ; Soto, Cristina Jorge ; Francisco Martín‐Rodríguez</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3484-1086e92696e4c3f456f8416d3aa7c62092300cec59e2d1de36eb55796e7884093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>early death</topic><topic>emergency department</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Emergency vehicles</topic><topic>Hospitals</topic><topic>lactate</topic><topic>Lactic acid</topic><topic>Mathematical analysis</topic><topic>modified Rapid Emergency Medicine Score</topic><topic>Mortality</topic><topic>mREMS‐L</topic><topic>Sensitivity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Donoso Calero, M Isabel</creatorcontrib><creatorcontrib>Laura Mordillo‐Mateos</creatorcontrib><creatorcontrib>José L Martín‐Conty</creatorcontrib><creatorcontrib>Begoña Polonio‐López</creatorcontrib><creatorcontrib>Ángel López‐González</creatorcontrib><creatorcontrib>Carlos Durantez‐Fernández</creatorcontrib><creatorcontrib>Viñuela, Antonio</creatorcontrib><creatorcontrib>Marta Rodríguez Hernández</creatorcontrib><creatorcontrib>Alicia Mohedano‐Moriano</creatorcontrib><creatorcontrib>Raúl López‐Izquierdo</creatorcontrib><creatorcontrib>Soto, Cristina Jorge</creatorcontrib><creatorcontrib>Francisco Martín‐Rodríguez</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library website</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Donoso Calero, M Isabel</au><au>Laura Mordillo‐Mateos</au><au>José L Martín‐Conty</au><au>Begoña Polonio‐López</au><au>Ángel López‐González</au><au>Carlos Durantez‐Fernández</au><au>Viñuela, Antonio</au><au>Marta Rodríguez Hernández</au><au>Alicia Mohedano‐Moriano</au><au>Raúl López‐Izquierdo</au><au>Soto, Cristina Jorge</au><au>Francisco Martín‐Rodríguez</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Modified Rapid Emergency Medicine Score‐Lactate (mREMS‐L) performance to screen non‐anticipated 30‐day‐related‐mortality in emergency department</atitle><jtitle>European journal of clinical investigation</jtitle><addtitle>Eur J Clin Invest</addtitle><date>2023-08</date><risdate>2023</risdate><volume>53</volume><issue>8</issue><spage>e13994</spage><epage>n/a</epage><pages>e13994-n/a</pages><issn>0014-2972</issn><eissn>1365-2362</eissn><abstract>Background
The aim of this study was to compare the ability to predict 30‐day in‐hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS‐L).
Methods
A prospective, multicentric, emergency department delivery, pragmatic study was conducted. To determine the predictive capacity of the scales, lactate was measured and the mREMS and mREMS‐L were calculated in adult patients (aged>18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon between 1 January 2020 and 31 December 2021. The area under the receiver operating characteristic (ROC) curve of each of the scales was calculated in terms of mortality for 30 days.
Results
A total of 5371 participants were included, and the in‐hospital mortality rate at 30 days was of 11.4% (615 cases). The best cut‐off point determined in the mREMS was 7.0 points (sensitivity of 67% and specificity of 84%), and for lactate, the cut‐off point was 1.4 mmol/L (sensitivity of 88% and specificity of 67%). Finally, the combined mREMS‐L showed a cut‐off point of 7.9 (sensitivity of 83% and a specificity of 83%). The area under the ROC curve of the mREMS, lactate and mREMS‐L for 30‐day mortality was 0.851, 0.853, and 0.903, respectively (p < 0.001 in all cases).
Conclusions
The new score generated, mREMS‐L, obtained better statistical results than its components (mREMS and lactate) separately.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>37000120</pmid><doi>10.1111/eci.13994</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4306-1607</orcidid><orcidid>https://orcid.org/0000-0001-8579-2323</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | early death emergency department Emergency medical care Emergency medical services Emergency vehicles Hospitals lactate Lactic acid Mathematical analysis modified Rapid Emergency Medicine Score Mortality mREMS‐L Sensitivity |
| title | Modified Rapid Emergency Medicine Score‐Lactate (mREMS‐L) performance to screen non‐anticipated 30‐day‐related‐mortality in emergency department |
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