Mortality risk model for patients with suspected COVID-19 based on information available from an emergency dispatch center
Martín-Rodríguez F, Sanz-García A, Alberdi Iglesias A, Ortega Rabbione G, del Pozo Vegas C, de la Torre-Díez I, Fernández Bayón G, Delgado Benito JF, Gómez-Escolar Pérez M, García Cortés JJ, López-Izquierdo R
Affiliation of the authors
Gerencia de Emergencias Sanitarias, Gerencia Regional de Salud de Castilla y León (SACYL), Spain. Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain. Hospital de la Princesa, Madrid, Spain. Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla y León (SACYL), Spain. Escuela Técnica Superior de Ingenieros de Telecomunicación, Universidad de Valladolid, Valladolid, Spain. Hospital de Medina del Campo, Gerencia Regional de Salud de Castilla y León (SACYL), Spain. Hospital Universitario Río Hortega de Valladolid, Gerencia Regional de Salud de Castilla y León (SACYL).
Martín-Rodríguez F, Sanz-García A, Alberdi Iglesias A, Ortega Rabbione G, del Pozo Vegas C, de la Torre-Díez I, et al. Mortality risk model for patients with suspected COVID-19 based on information available from an emergency dispatch center. Emergencias. 2021;33:265-72
Summary
Objective.
To develop and validate a scale to stratify risk of 2-day mortality based on data collected during calls to an emergency dispatch center from patients with suspected coronavirus disease 2019 (COVID-19).
Methods.
Retrospective multicenter study of consecutive patients over the age of 18 years with suspected COVID-19 who were transported from home over the course of 3 months after telephone interviews with dispatchers. We analyzed clinical and epidemiologic variables and comorbidities in relation to death within 2 days of the call. Using data from the development cohort, we built a risk model by means of logistic regression analysis of categorical variables that were independently associated with 2-day mortality. The scale was validated first in a validation cohort in the same province and then in a cohort in a different province.
Results.
A total of 2320 patients were included. The mean age was 79 years, and 49.8% were women. The overall 2-day mortality rate was 22.6% (376 deaths of patients with severe acute respiratory syndrome coronavirus 2 infection). The model included the following factors: age, location (rural location as a protective factor), institutionalization, desaturation, lung sounds (rhonchi), and altered mental status. The area under the receiver operating characteristic curve for death within 2 days was 0.763 (95% CI, 0.725–0.802; P < .001). Mortality in patients at high risk (more than 2.4 points on the scale) was 60%.
Conclusions.
This risk scale derived from information available to an emergency dispatch center is applicable to patients with suspected COVID-19. It can stratify patients by risk of early death (within 2 days), possibly helping with decision making regarding whether to transport from home or what means of transport to use, and destination.
