Abstract

Aims: Emergency medicine is a new specialty that started in India in 2012 to treat severely ill patients as soon as possible. The main principle is triage which is useful for patient treatment and counseling of attenders regarding prognosis. Material and Methods: A prospective study was conducted in the adult ED of a 1200-bed hospital. A total of thousand patients presented with acute medical conditions were included in the study. Data collected at admission included pulse rate, respiratory rate, mean arterial pressure, mental status, pulse oximetry, age, blood pressure, and Glasgow coma scale. Aim was to investigate relationship between the scoring systems to predict in-hospital mortality. Results: In our study majority of the population was male and in the age group of 21 to 30 years. Cases admitted in ICU (62%) were higher than in wards (38%).The HOTEL score showed a better prediction of mortality compared with REMS and MEWS. Conclusion: A HOTEL score of more than 1, predicts ICU admission and in-hospital mortality compared to MEWS and REMS.

• 1.   Subbe CP, Davies RG, Williams E, et al. Effect of introducing the Modied Early Warning score on clinical outcomes, cardio-pulmonary arrests and intensive care utilisation in acute medical admissions. Anaesthesia. 2003;58:797e802.
• 2.   Prytherch DR, Smith GB, Schmidt PE, et al. ViEWSdTowards a national early warning score for detecting adult inpatient deterioration. Resuscitation. 2010;81:932e937.
• 3.   Crowe CA, Kulstad EB, Mistry CD, et al. Comparison of severity of illness scoring systems in the prediction of hospital mortality in severe sepsis and septic shock. J Emerg Trauma Shock. 2010;3:342e347.
• 4.   Cuthbertson BH, Boroujerdi M, Prescott G. The use of combined physiological parameters in the early recognition of the deteriorating acute medical patient. J R Coll Physicians Edinb. 2010;40:19e25.
• 5.   Olsson T, Terent A, Lind L. Rapid Emergency Medicine Score: a new prognostic tool for in-hospital mortality in nonsurgical emergency department patients. J Intern Med. 2004;255:579e587.
• 6.   Olsson T, Lind L. Comparison of the rapid emergency medicine score and APACHE II in nonsurgical emergency department patients. Acad Emerg Med. 2003;10:1040e1048.
• 7.   Bulut M, Cebicci H, Sigirli D, et al. The comparison of modied early warning score with rapid emergency medicine score: a prospective multicentre observational cohort study on medical and surgical patients presenting to emergency department. Emerg Med J. 2014;31:476e481.
• 8.   Goodacre S, Turner J, Nicholl J. Prediction of mortality among emergency medical admissions. Emerg Med J. 2006; 23:372e375.
• 9.   Sharma M, Szpunar S, Khatib R. Validating severity of illness scoring systems in the prediction of outcomes in Staphylococcus aureus bacteremia. Am J Med Sci.2013;346:87e91.
• 10.   Kellett J, Deane B, Gleeson M. Derivation and validation of a score based on Hypotension, Oxygen saturation, low Temperature, ECG changes and Loss of independence (HOTEL) that predicts early mortality between 15 min and 24 hrs after admission to an acute medical unit. Resuscitation. 2008;78:52e58.
• 11.   Wheeler I, Price C, Sitch A, et al. Early warning scores generated in developed healthcare settings are not sufcient at predicting early mortality in Blantyre, Malawi: a prospective cohort study. PLoS One. 2013;8:e59830.
• 12.   Jo S, Lee JB, Jin YH, et al. Modied early warning score with rapid lactate level in critically ill medical patients: the ViEWS-L score. Emerg Med J. 2013;30:123e129.
• 13.   Imhoff BF, Thompson NJ, Hastings MA, et al. Rapid Emergency Medicine Score (REMS) in the trauma population: a retrospective study. BMJ Open. 2014;4:e004738.
• 14.   Kuo SH, Tsai CF, Li CR, et al. Rapid Emergency Medicine Score as a main predictor of mortality in Vibrio vulnicus-related patients. Am J Emerg Med. 2013;31:1037e1041.
• 15.   Olsson T, Terént A, Lind L. Rapid Emergency Medicine Score: a new prognostic tool for in hospital mortality in nonsurgical emergency department patients. Journal of internal medicine. 2004 May; 255(5):579-87.
• 16.   Assess the rapid emergency medicine score (rems) and hotel score to identify among nonsurgical emergency patients [Internet]. [cited 2023 Jun 8]. Available from: https:// cardiometry.net/issues/no26-february-2023/ assess-rapid-emergency-medicine.

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