Performance of scoring systems in selecting short stay medical admissions suitable for assessment in same day emergency care: an analysis of diagnostic accuracy in a UK hospital setting.
Performance of scoring systems in selecting short stay medical admissions suitable for assessment in same day emergency care: an analysis of diagnostic accuracy in a UK hospital setting.
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DOI：
10.1136/bmjopen-2022-064910
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发表时间：
2022-12-16
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
评估Amb评分和格拉斯哥入院预测评分（GAPS）在大型城市二级中心确定适合当天急诊（SDEC）的急性医疗入院的性能。回顾性评估从电子医疗记录中常规收集的数据。单一的大型城市三级护理中心。周一至周五所有计划外的普通医学入院，发作时间从08：00-16：59小时开始，持续时间长达48小时，2019年4月1日至2020年3月9日。Amb评分和GAPS在识别到达后12小时内出院的患者方面的敏感性、特异性、阳性和阴性预测值。共评估了7365次发作。94.6%的发作的Amb评分表明适合SDEC。Amb评分对12小时内出院患者的阳性预测值为54.5%（95%CI 53.3%至55.8%）。Amb评分的受试者工作特征曲线下面积（AUROC）为0.612（95% CI 0.599 - 0.625）。42.4%的发作有GAPS，表明适合SDEC。GAPS在识别12小时内出院者方面的阳性预测值为50.5%（95%CI 48.4%至52.7%）。GAPS的AUROC为0.606（95% CI 0.590至0.622）。41.4%的人群同时具有Amb和GAPS评分，提示适合SDEC，5.7%的人群同时具有Amb和GAPS评分，提示不适合SDEC。Amb评分和GAPS在识别适合在12小时内出院的急性医疗入院方面的区分能力较差，限制了其在选择SDEC服务中评估患者的效用。
To assess the performance of the Amb score and Glasgow Admission Prediction Score (GAPS) in identifying acute medical admissions suitable for same day emergency care (SDEC) in a large urban secondary centre. Retrospective assessment of routinely collected data from electronic healthcare records. Single large urban tertiary care centre. All unplanned admissions to general medicine on Monday–Friday, episodes starting 08:00–16:59 hours and lasting up to 48 hours, between 1 April 2019 and 9 March 2020. Sensitivity, specificity, positive and negative predictive value of the Amb score and GAPS in identifying patients discharged within 12 hours of arrival. 7365 episodes were assessed. 94.6% of episodes had an Amb score suggesting suitability for SDEC. The positive predictive value of the Amb score in identifying those discharged within 12 hours was 54.5% (95% CI 53.3% to 55.8%). The area under the receiver operating characteristic curve (AUROC) for the Amb score was 0.612 (95% CI 0.599 to 0.625). 42.4% of episodes had a GAPS suggesting suitability for SDEC. The positive predictive value of the GAPS in identifying those discharged within 12 hours was 50.5% (95% CI 48.4% to 52.7%). The AUROC for the GAPS was 0.606 (95% CI 0.590 to 0.622). 41.4% of the population had both an Amb and GAPS score suggestive of suitability for SDEC and 5.7% of the population had both and Amb and GAPS score suggestive of a lack of suitability for SDEC. The Amb score and GAPS had poor discriminatory ability to identify acute medical admissions suitable for discharge within 12 hours, limiting their utility in selecting patients for assessment within SDEC services within this diverse patient population.
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影响因子：
4.4
作者：
Ala, Les;Mack, Jennifer;Rathbone, Nia
通讯作者：
Rathbone, Nia
影响因子：
--
作者：
Atkin, C;Knight, T;Lasserson, D
通讯作者：
Lasserson, D
影响因子：
2.9
作者：
Pendlebury ST;Lovett NG;Smith SC;Dutta N;Bendon C;Lloyd-Lavery A;Mehta Z;Rothwell PM
通讯作者：
Rothwell PM
影响因子：
3.3
作者：
Baier, Natalie;Geissler, Alexander;Quentin, Wilm
通讯作者：
Quentin, Wilm
影响因子：
3.1
作者：
Cameron, Allan;Jones, Dominic;Lowe, David J.
通讯作者：
Lowe, David J.