RAPID-ED: A predictive model for risk assessment of patient's early in-hospital deterioration from emergency department

Yi Min Wang, I. Min Chiu, Yu Ping Chuang, Chi Yung Cheng, Chun Fu Lin, Fu Jen Cheng, Chien Fu Lin*, Chao Jui Li

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

1 Scopus citations

Abstract

Introduction: The objective of this multi-center retrospective cohort study was to devise a predictive tool known as RAPID-ED. This model identifies non-traumatic adult patients at significant risk for cardiac arrest within 48 hours post-admission from the emergency department. Methods: Data from 224,413 patients admitted through the emergency department (2016–2020) was analyzed, incorporating vital signs, lab tests, and administered therapies. A multivariable regression model was devised to anticipate early cardiac arrest. The efficacy of the RAPID-ED model was evaluated against traditional scoring systems like National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) and its predictive ability was gauged via the area under the receiver operating characteristic curve (AUC) in both hold-out validation set and external validation set. Results: RAPID-ED outperformed traditional models in predicting cardiac arrest with an AUC of 0.819 in the hold-out validation set and 0.807 in the external validation set. In this critical care update, RAPID-ED offers an innovative approach to assessing patient risk, aiding emergency physicians in post-discharge care decisions from the emergency department. High-risk score patients (≥13) may benefit from early ICU admission for intensive monitoring. Conclusion: As we progress with advancements in critical care, tools like RAPID-ED will prove instrumental in refining care strategies for critically ill patients, fostering an improved prognosis and potentially mitigating mortality rates.

Original languageEnglish
Article number100570
Pages (from-to)100570
JournalResuscitation Plus
Volume17
DOIs
StatePublished - 03 2024

Bibliographical note

© 2024 The Authors.

Keywords

  • Emergency medicine
  • ICU
  • In-hospital mortality
  • Mechanical ventilation
  • Predictive model

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