Death risk classifying in patients with internal medical emergencies in pre-hospital settings

Abstract

Introduction: In a pre-hospital emergency, identifying high-risk medical patients and appropriate decision making is very important. The classifying of life-threatening risks in pre-hospital settings can improve the decision-making process. This study was purposed to classify the risk level of death in patients in pre-hospital emergency settings. Materials and Methods: This study was a descriptive longitudinal study design that performed on the patients requesting the pre-hospital emergency services. This study was a descriptive longitudinal descriptive study that lasted from May 1 to the end of August 2017. 675 patients participated in this study. A demographic questionnaire and pre-hospital internal emergency alert scale were used for data collection. Then the patients' condition was followed up until discharge from the emergency department. Results: The mean score of the Pre-Hospital Internal Emergency Warning Scale was 11.95 ± 6.21. The odds ratio for each Prehospital Medical Early Warning Scale (Pre-MEWS) score was 1.193, which indicated for each unit increase in Pre-MEWS scores, the risk of death of patients increased by 19.3%. Then, the patients classified into three levels of green, yellow, and red based on Pre-MEWS scores. The Area Under the Rock curve for Pre-MEWS scores to identify death and the need for hospitalization in intensive care units was equal to 0.847 (CI=0.793-0.901), and0.755 (CI= 0.711-0.799) respectively). Conclusion: The Pre-MEWS scale can use for classifying and triage of patients in pre-hospital emergencies, especially in times of disaster. According to the Pre-MEWS scale, patients who are in the third level or green color can transfer to the hospital with more delay, and this can improve the quality of pre-hospital emergency services in times of disaster.