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A Study of Initial Assessment of Emergency Patients Using REMS Score and HOTEL Score

Rajanikanth S Malapur, Associate Professor, Department of Emergency medicine, SDM Medical College, Sattur, Dharwad, Karnataka 580009, India , Shabbir Shekhli1 , Saikiran G.2 , Rajanikanth S. Malapur3

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Indian Journal of Emergency Medicine 4(4):p 261-267, Oct-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.4418.1

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Abstract

  Aims: To assess the prognostic values and predicting in-hospital mortality of patients admitted to ED by Rapid Emergency Medicine Score (REMS) and Hypotension, oxygenation, temperature, ECG abnormality, loss of independence (HOTEL) scores. Methods and Material: Patient presenting to ED were evaluated at admission with detailed history and physical examination. The data of the patients fulfilling the study inclusion criteria were recorded as follows: age; sex; blood pressure; pulse rate; respiratory frequency; temperature; oxygen saturation; Glasgow Coma Scale; ECG findings; and loss of independence. Statistical analysis used: mean and standard deviation for quantitative variables, Chi Square test, a comparison of the diagnostic abilities for each test was performed using the area under the curves (AUC). SPSS for Windows Version 22.0 Released 2013 was used. Results: 100 patients were included in the study, of which 26 died and 74 survived. In predicting the in-hospital mortality, the AUC values of the REMS and HOTEL scores
0.808, (95% CI=0.719-0.879) were (p<0.001) and 0.874, (95% CI=0.794-0.931) were (p<0.001) respectively. Conclusions: The HOTEL score demonstrated the largest AUC (area under curve) of the studied scoring systems for the outcome of mortality. 

Keywords: HOTEL; REMS; Survivors; Nonsurvivors; ED-Emergency
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DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.4418.1

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