Summary

Long-term risk of death in patients with infection attended by prehospital emergency services

Laura Melero Guijarro1, Francisco Martín-Rodríguez2,3, Jesús Álvarez Manzanares1, Carlos del Pozo Vegas4, Ancor Sanz García5, Miguel Ángel Castro Villamor2, Raúl López-Izquierdo1,2,6

Affiliation of the authors

1Servicio de Urgencias, Hospital Universitario Rio Hortega de Valladolid, Gerencia Regional de Salud de Castilla y León (SACYL), Spain. 2Facultad de Medicina, Universidad de Valladolid, Spain. 3Gerencia de Emergencias Sanitarias, Gerencia Regional de Salud de Castilla y León (SACYL), Spain. 4Servicio de Urgencias, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla y León (SACYL), Spain. 5Facultad de Ciencias de la Salud, Universidad de Castilla la Mancha, Talavera de la Reina, Spain. 6CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

DOI

Quote

Melero Guijarro L, Martín-Rodríguez F, Álvarez Manzanares J, del Pozo Vegas C, Sanz García A, Castro Villamor MA, et al. Long-term risk of death in patients with infection attended by prehospital emergency services. Emergencias. 2024;36:088-096

Summary

Objectives.

To develop and validate a risk model for 1-year mortality based on variables available from early prehospital emergency attendance of patients with infection.

Methods.

Prospective, observational, noninterventional multicenter study in adults with suspected infection transferred to 4 Spanish hospitals by advanced life-support ambulances from June 1, 2020, through June 30, 2022. We collected demographic, physiological, clinical, and analytical data. Cox regression analysis was used to develop and validate a risk model for 1-year mortality.

Results.

Four hundred ten patients were enrolled (development cohort, 287; validation cohort, 123). Cumulative mortality was 49% overall. Sepsis (infection plus a Sepsis-related Organ Failure Assessment score of 2 or higher) was diagnosed in 29.2% of survivors vs 56.7% of nonsurvivors. The risk model achieved an area under the receiver operating characteristic curve of 0.89 for 1-year mortality. The following predictors were included in the model: age; institutionalization; age-adjusted Charlson comorbidity index; PaCO2; potassium, lactate, urea nitrogen, and creatinine levels; fraction of inspired oxygen; and diagnosed sepsis.

Conclusions.

The model showed excellent ability to predict 1-year mortality based on epidemiological, analytical, and clinical variables, identifying patients at high risk of death soon after their first contact with the health care system.

 

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