Physicians’ Disease Severity Ratings are Non-Inferior to the Emergency Severity Index
Abstract
:1. Introduction
1.1. Background
1.2. Goals of This Investigation
2. Materials and Methods
2.1. Study Design and Setting
2.2. Physician Disease Severity Rating (PDSR)
2.3. Selection of Participants
2.4. Methods of Measurement
2.5. Outcome Measures
2.6. Primary Data Analysis
2.7. Noninferiority Method
2.8. Secondary Data Analysis
3. Results
3.1. Characteristics of Study Subjects
3.2. Main Results
4. Limitations
5. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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N (%) | Age, Median (IQR) | Male % | Hospitali- zation (%) | ICU Admission n (%) | In-hospital Mortality n (%) | 30 Day Mortality, n (%) * | |
---|---|---|---|---|---|---|---|
All patients | 6859 | 51 (33–72) | 51.4 | 2265 (33.0) | 409 (6.0) | 105 (1.5) | 159 (2.4) |
ESI | |||||||
1 | 165 (2.4) | 68 (55–80) | 58.8 | 148 (89.7) | 87 (52.7) | 38 (23.0) | 45 (29.4) |
2 | 1478 (21.5) | 62 (44–77) | 53.9 | 859 (58.1) | 205 (13.9) | 35 (2.4) | 51 (3.6) |
3 | 2760 (40.2) | 58 (39–77) | 49.1 | 1146 (41.5) | 108 (3.9) | 31 (1.1) | 59 (2.2) |
4 | 2260 (33.0) | 38 (27–53) | 51.9 | 109 (4.8) | 8 (0.3) | 1 (0.1) | 3 (0.1) |
5 | 196 (2.9) | 40 (27–56) | 52 | 3 (1.5) | 1 (0.5) | 0 (0.0) | 1 (0.5) |
PDSR | |||||||
5 | 260 (3.8) | 70 (52–82) | 56.5 | 226 (86.9) | 109 (41.9) | 48 (18.5) | 62 (24.8) |
4 | 891 (13.0) | 66 (48–80) | 53.5 | 622 (69.8) | 153 (17.2) | 28 (3.1) | 40 (4.7) |
3 | 1454 (21.2) | 60 (41–77) | 47.9 | 727 (50.0) | 87 (6.0) | 19 (1.3) | 40 (2.8) |
2 | 2354 (34.3) | 49 (32–68) | 51.4 | 546 (23.2) | 53 (2.2) | 5 (0.2) | 10 (0.4) |
1 | 1900 (27.7) | 40 (28–57) | 52.2 | 144 (7.6) | 7 (0.4) | 5 (0.3) | 7 (0.4) |
Age | Gender | PDSR | ESI | Rater A | Rater B | Reference ESI | Reason for Presentation | Cause of Death |
---|---|---|---|---|---|---|---|---|
74 | Male | 2 | 1 | 2 | 2 | 2 | Treated hypoglycemia | Bronchial carcinoma |
87 | Male | 2 | 2 | 2 | 2 | 2 | Weakness, Anemia | Leukemia, fungal pneumonia |
89 | Male | 2 | 2 | 2 | 2 | 2 | Aspiration | Unknown |
90 | Female | 2 | 3 | 2 | 2 | 2 | Weakness | Influenza A |
87 | Female | 2 | 3 | 2 | 2 | 2 | Syncope | Tachy-/bradycardia syndrome, severe aortic valve stenosis |
70 | Male | 2 | 3 | 2 | 2 | 2 | Dizziness | Septic shock, bilateral pneumonia |
97 | Female | 2 | 3 | 2 | 3 | 2 | Leg pain, Dyspnea | Septic shock, heart failure |
77 | Male | 2 | 3 | 3 | 4 | 3 | Back pain | Heart failure |
79 | Female | 2 | 3 | 3 | 3 | 3 | Epistaxis | Kidney abscess |
69 | Female | 1 | 3 | 3 | 3 | 3 | Epistaxis | Suicide |
90 | Male | 1 | 3 | 2 | 2 | 2 | Low energy fall | Myocardial infarction, pneumonia |
89 | Male | 1 | 3 | 3 | 3 | 3 | Aspiration | Heart failure, pneumonia |
91 | Female | 1 | 3 | 2 | 2 | 2 | Gait instability | Bronchial carcinoma, delirium |
86 | Female | 2 | 4 | 2 | 3 | 2 | Low energy fall | Subdural hematoma |
68 | Male | 1 | 4 | 4 | 4 | 4 | Urinary catheter insertion | Unknown |
72 | Male | 1 | 4 | 3 | 4 | 4 | Discomfort by urinary catheter | Unknown |
86 | Male | 1 | 5 | 2 | 4 | 2 | Urinary catheter insertion | Delirium |
ESI | |||||
---|---|---|---|---|---|
PDSR | 5 | 4 | 3 | 2 | 1 |
1 | 141 | 1105 | 512 | 137 | 5 |
2 | 48 | 907 | 1051 | 338 | 10 |
3 | 5 | 204 | 841 | 390 | 14 |
4 | 2 | 41 | 314 | 484 | 50 |
5 | 0 | 3 | 42 | 129 | 86 |
N | Age, Median (IQR) | Male % | Hospitalization, n (%) | ICU Admission, n (%) | In-hospital Mortality, n (%) | 30 day Mortality, n (%)* | |||
---|---|---|---|---|---|---|---|---|---|
ESI 1 | PDSR | =5 | 86 | 71 (58–80) | 61.6 | 84 (97.7) | 55 (64.0) | 31 (36.1) | 36 (43.9) |
<5 | 79 | 68 (54–80) | 55.7 | 64 (81.0) | 32 (40.5) | 7 (8.9) | 9 (12.7) | ||
ESI 2 | PDSR | =5 | 129 | 70 (50–82) | 56.6 | 104 (80.6) | 45 (34.9) | 14 (10.9) | 20 (16.1) |
<5 | 1349 | 61 (43–77) | 53.6 | 755 (56.0) | 160 (11.9) | 21 (1.6) | 31 (2.4) | ||
ESI 3 | PDSR | =5 | 42 | 73 (52–83) | 47.6 | 36 (85.7) | 8 (19.0) | 3 (7.1) | 6 (14.6) |
<5 | 2718 | 58 (39–77) | 49.1 | 1110 (40.8) | 100 (3.7) | 28 (1.0) | 53 (2.0) | ||
ESI 4 | PDSR | =5 | 3 | 57 (48–62) | 33.3 | 2 (66.6) | 1 (33.3) | 0 (0) | 0 (0) |
<5 | 2257 | 38 (27–53) | 52.0 | 107 (4.8) | 7 (0.3) | 1 (0.1) | 3 (0.1) | ||
ESI 5 | PDSR | =5 | 0 | - | - | - | - | - | - |
<5 | 196 | 40 (27–56) | 52.0 | 3 (1.5) | 1 (0.5) | 0 (0.0) | 1 (0.5) |
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Bingisser, R.; Baerlocher, S.M.; Kuster, T.; Nieves Ortega, R.; Nickel, C.H. Physicians’ Disease Severity Ratings are Non-Inferior to the Emergency Severity Index. J. Clin. Med. 2020, 9, 762. https://doi.org/10.3390/jcm9030762
Bingisser R, Baerlocher SM, Kuster T, Nieves Ortega R, Nickel CH. Physicians’ Disease Severity Ratings are Non-Inferior to the Emergency Severity Index. Journal of Clinical Medicine. 2020; 9(3):762. https://doi.org/10.3390/jcm9030762
Chicago/Turabian StyleBingisser, Roland, Severin Manuel Baerlocher, Tobias Kuster, Ricardo Nieves Ortega, and Christian H. Nickel. 2020. "Physicians’ Disease Severity Ratings are Non-Inferior to the Emergency Severity Index" Journal of Clinical Medicine 9, no. 3: 762. https://doi.org/10.3390/jcm9030762