A Comparison of the Clinical Characteristics of Short-, Mid-, and Long-Term Mortality in Patients Attended by the Emergency Medical Services: An Observational Study
Rodrigo Enriquez de Salamanca Gambara,
Ancor Sanz-García,
Carlos del Pozo Vegas,
Raúl López-Izquierdo,
Irene Sánchez Soberón,
Juan F. Delgado Benito,
Raquel Martínez Diaz,
Cristina Mazas Pérez-Oleaga,
Nohora Milena Martínez López,
Irma Domínguez Azpíroz,
Francisco Martín-Rodríguez
Affiliations
Rodrigo Enriquez de Salamanca Gambara
Emergency Department, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain
Ancor Sanz-García
Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain
Carlos del Pozo Vegas
Faculty of Medicine, Universidad de Valladolid, 47011 Valladolid, Spain
Raúl López-Izquierdo
Emergency Department, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain
Irene Sánchez Soberón
Advanced Life Support, Emergency Medical Services (SACYL), 47007 Valladolid, Spain
Juan F. Delgado Benito
Advanced Life Support, Emergency Medical Services (SACYL), 47007 Valladolid, Spain
Raquel Martínez Diaz
Department of Project Management, Universidad Europea del Atlántico, 39011 Santander, Spain
Cristina Mazas Pérez-Oleaga
Department of Project Management, Universidad Europea del Atlántico, 39011 Santander, Spain
Nohora Milena Martínez López
Department of Project Management, Universidad Europea del Atlántico, 39011 Santander, Spain
Irma Domínguez Azpíroz
Department of Project Management, Universidad Europea del Atlántico, 39011 Santander, Spain
Francisco Martín-Rodríguez
Faculty of Medicine, Universidad de Valladolid, 47011 Valladolid, Spain
Aim: The development of predictive models for patients treated by emergency medical services (EMS) is on the rise in the emergency field. However, how these models evolve over time has not been studied. The objective of the present work is to compare the characteristics of patients who present mortality in the short, medium and long term, and to derive and validate a predictive model for each mortality time. Methods: A prospective multicenter study was conducted, which included adult patients with unselected acute illness who were treated by EMS. The primary outcome was noncumulative mortality from all causes by time windows including 30-day mortality, 31- to 180-day mortality, and 181- to 365-day mortality. Prehospital predictors included demographic variables, standard vital signs, prehospital laboratory tests, and comorbidities. Results: A total of 4830 patients were enrolled. The noncumulative mortalities at 30, 180, and 365 days were 10.8%, 6.6%, and 3.5%, respectively. The best predictive value was shown for 30-day mortality (AUC = 0.930; 95% CI: 0.919–0.940), followed by 180-day (AUC = 0.852; 95% CI: 0.832–0.871) and 365-day (AUC = 0.806; 95% CI: 0.778–0.833) mortality. Discussion: Rapid characterization of patients at risk of short-, medium-, or long-term mortality could help EMS to improve the treatment of patients suffering from acute illnesses.