{"pk":15356,"title":"Development and Validation of a Novel Triage Tool for Predicting Cardiac Arrest in the Emergency Department","subtitle":null,"abstract":"Background: \nEarly recognition and prevention of in-hospital cardiac arrest (IHCA) have played an  increasingly important role in the chain of survival. However, clinical tools for predicting IHCA are  scarce, particularly in the emergency department (ED). We sought to estimate the incidence of ED-based IHCA and to develop and validate a novel triage tool, the Emergency Department In-hospital  Cardiac Arrest Score (EDICAS), for predicting ED-based IHCA.\nMethods:\n In this retrospective cohort study we used electronic clinical warehouse data from a  tertiary medical center with approximately 100,000 ED visits per year. We extracted data from  733,398 ED visits over a seven-year period. We selected one ED visit per person and excluded out-of-hospital cardiac arrest or children. Patient demographics and computerized triage information  were included as potential predictors.\nResults:\n A total of 325,502 adult ED patients were included. Of these patients, 623 (0.2%)  developed ED-based IHCA. The EDICAS, which includes age and arrival mode and categorizes  vital signs with simple cut-offs, showed excellent discrimination (area under the receiver operating  characteristic [AUROC] curve, 0.87) and maintained its discriminatory ability (AUROC, 0.86) in  cross-validation. Previously developed early warning scores showed lower AUROC (0.77 for the  Modified Early Warning Score and 0.83 for the National Early Warning Score) when applied to our  ED population.\nConclusion:\n In-hospital cardiac arrest in the ED is relatively uncommon. We developed and  internally validated a novel tool for predicting imminent IHCA in the ED. Future studies are warranted  to determine whether this tool could gain lead time to identify high-risk patients and potentially  reduce ED-based IHCA.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Critical Care","is_remote":true,"remote_url":"https://escholarship.org/uc/item/476689hg","frozenauthors":[{"first_name":"Chu-Lin","middle_name":"","last_name":"Tsai","name_suffix":"","institution":"National Taiwan University Hospital Department of Emergency Medicine, Taipei, Taiwan\nNational Taiwan University College of Medicine, Department of Emergency Medicine, \nTaipei, Taiwan","department":"None"},{"first_name":"Tsung-Chien","middle_name":"","last_name":"Lu","name_suffix":"","institution":"National Taiwan University Hospital Department of Emergency Medicine, Taipei, Taiwan\nNational Taiwan University College of Medicine, Department of Emergency Medicine, \nTaipei, Taiwan","department":"None"},{"first_name":"Cheng-Chung","middle_name":"","last_name":"Fang","name_suffix":"","institution":"National Taiwan University Hospital Department of Emergency Medicine, Taipei, Taiwan\nNational Taiwan University College of Medicine, Department of Emergency Medicine, \nTaipei, Taiwan","department":"None"},{"first_name":"Chih-Hung","middle_name":"","last_name":"Wang","name_suffix":"","institution":"National Taiwan University Hospital Department of Emergency Medicine, Taipei, Taiwan\nNational Taiwan University College of Medicine, Department of Emergency Medicine, \nTaipei, Taiwan","department":"None"},{"first_name":"Jia-You","middle_name":"","last_name":"Lin","name_suffix":"","institution":"National Taiwan University Hospital Department of Emergency Medicine, Taipei, Taiwan","department":"None"},{"first_name":"Wen-Jone","middle_name":"","last_name":"Chen","name_suffix":"","institution":"National Taiwan University Hospital Department of Emergency Medicine, Taipei, Taiwan\nNational Taiwan University College of Medicine, Department of Emergency Medicine, \nTaipei, Taiwan","department":"None"},{"first_name":"Chien-Hua","middle_name":"","last_name":"Huang","name_suffix":"","institution":"National Taiwan University Hospital Department of Emergency Medicine, Taipei, Taiwan\nNational Taiwan University College of Medicine, Department of Emergency Medicine, \nTaipei, Taiwan","department":"None"}],"date_submitted":"2021-05-06T07:56:34-04:00","date_accepted":"2021-05-06T07:56:34-04:00","date_published":"2022-02-24T00:10:39-05:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/15356/galley/7772/download/"}]}