title: Development and validation of a prognostic model for predicting 30-day mortality risk in medical patients in emergency department (ED).
abstract: The primary aim of this prospective study is to develop and validate a new prognostic model for predicting the risk of mortality in Emergency Department (ED) patients. The study involved 1765 patients in the development cohort and 1728 in the validation cohort. The main outcome was mortality up to 30 days after admission. Potential risk factors included clinical characteristics, vital signs, and routine haematological and biochemistry tests. The Bayesian Model Averaging method within the Cox's regression model was used to identify independent risk factors for mortality. In the development cohort, the incidence of 30-day mortality was 9.8%, and the following factors were associated with a greater risk of mortality: male gender, increased respiratory rate and serum urea, decreased peripheral oxygen saturation and serum albumin, lower Glasgow Coma Score, and admission to intensive care unit. The area under the receiver operating characteristic curve for the model with the listed factors was 0.871 (95% CI, 0.844-0.898) in the development cohort and 0.783 (95% CI, 0.743-0.823) in the validation cohort. Calibration analysis found a close agreement between predicted and observed mortality risk. We conclude that the risk of mortality among ED patients could be accurately predicted by using common clinical signs and biochemical tests.
authors.affiliation: Intensive Care Unit, National Hospital of Can Tho, Vietnam.|Research Center for Genetics and Reproductive Health, School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam.|Van Phuoc Mekong Hospital, Can Tho, Vietnam.
authors.forename: Duc T
authors.initials: DT
authors.lastname: Ha
authors.affiliation: Intensive Care Unit, National Hospital of Can Tho, Vietnam.
authors.forename: Tam Q
authors.initials: TQ
authors.lastname: Dang
authors.affiliation: Department of Internal Medicine, University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam.
authors.forename: Ngoc V
authors.initials: NV
authors.lastname: Tran
authors.affiliation: Department of Intensive Care Medicine, Emergency Medicine and Clinical Toxicology, University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam.|Intensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
authors.forename: Thao N T
authors.initials: TN
authors.lastname: Pham
authors.affiliation: Ton Duc Thang University, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen D
authors.initials: ND
authors.lastname: Nguyen
authors.affiliation: Ton Duc Thang University, Ho Chi Minh City, Vietnam.|Garvan Institute of Medical Research, Sydney, Australia.|School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.|Centre for Health Technologies, University of Technology, Sydney, Australia.
authors.forename: Tuan V
authors.initials: TV
authors.lastname: Nguyen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001499:Bayes Theorem; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009026:Mortality; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors