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01 November 2022: Clinical Research

A Prospective Observational Study Conducted at a Single Center in Japan to Validate a Previously Developed Predictive Formula of In-Hospital Mortality for Patients Aged ≥65 Years with Endogenous Diseases Transported by Ambulance

Motoshi Fujiwara 1ABDEF* , Masaki Tago 1ABDEFG** , Risa Hirata 1BCDEF , Shun Yamashita 1BCDF , Naoko E. Katsuki 1CDF , Noriko Ide 12ABD , Tomoyo M. Nishi 12ABD , Yoshimasa Oda 2ABD , Masanori Nishiyama 2AD , Shu-ichi Yamashita 1ADEG

DOI: 10.12659/MSM.938385

Med Sci Monit 2022; 28:e938385

Table 1 Patient backgrounds.

All patients (n=325)Group D (In-hospital death) (n=42)Group S (Surviving) (n=283)p value
Age* 84 (78–91)89 (84–94)84 (77–91)0.001
Aged ≥90 years107 (33)20 (48)87 (31)0.030
Men139 (43)20 (48)119 (42)0.496
Duration of hospitalization* 12 (6–21)8 (4–20)13 (6–22)0.053
Infusion volume at 24 hours (mL)* 1775 (1200–2500)1800 (1200–2650)1760 (1200–2450)0.862
Vasopressors23 (7)7 (17)16 (6)0.009
Treated by the primary care physician56 (17)7 (17)49 (17)0.917
Prehospital treatment4 (1)1 (2)3 (1)0.469
Peripheral access before hospital visit39 (12)7 (17)32 (11)0.319
Number of prescribed drugs,* 6 (3–9)8 (5–10)6 (3–8)0.031
Antihypertensive medications*** 199/288 (69)24/36 (67)175/252 (69)0.736
Vital signs
 GCS-E* 4 (4–4)4 (3–4)4 (4–4)0.003
 GCS-V* 5 (4–5)4 (2–5)5 (4–5)
 GCS-M* 6 (6–6)6 (5–6)6 (6–6)0.001
 GCS-Total* 15 (14–15)14 (11–15)15 (14–15)
 Disturbance of consciousness106/323 (33)24/42 (57)82/281 (11)
 Body temperature* 37 (36–38)37 (36–38)37 (36–38)0.379
 Pulse rate (beats/min)* 86 (72–102)91 (77–112)86 (72–101)0.115
 Systolic BP* 142 (117–163)133 (108–170)142 (120–163)0.575
 Diastolic BP* 79 (68–93)79 (66–102)79 (68–92)0.502
 Respiration rate (breaths/min)* 20 (17–22)22 (18–24)19 (16–22)0.068
 SpO* 97 (95–99)96 (93–98)97 (95–99)0.004
Shock index ≥1**** 40/322 (12)8/41 (20)32/281 (11)0.141
Shock index,* 0.6 (0.5–0.8)0.7 (0.5–0.9)0.6 (0.5–0.8)0.109
Age × Shock index,* 52 (41–66)64 (45–81)51 (40–63)0.029
q-SOFA* 1 (0–1)1 (1–2)1 (0–1)
 q-SOFA ≥252 (16)16 (38)36 (13)
Oxygen administration* 0 (0–3)3 (0–6)0 (0–3)0.010
 Oxygen administration ≥5 L/min66 (20)17 (40)49 (17)
Barthel Index* 55 (15–90)15 (0–36)60 (20–95)
ABC Dementia Scale* 97 (66–117)69 (53–104)101 (68–117)
Bedriddenness rank
 Normal62 (19)062 (22)
 J: J1 + J222 (7)022 (8)
 A: A1 + A251 (16)5 (12)46 (16)
 B: B1 + B259 (18)2 (5)57 (20)
 C: C1 + C2131 (40)35 (83)96 (34)
Cognitive function score0.005
 Normal113 (35)5 (12)108 (38)
 I46 (14)6 (14)40 (14)
 II: IIa + IIb70 (22)11 (26)59 (21)
 III: IIIa + IIIb79 (24)15 (36)64 (23)
 IV17 (5)5 (12)12 (4)
* These values are median (interquartile range). The other values are n (%);
** n=288;
*** antihypertensive medications as those taking one or more of the following: α-blockers, β-blockers, calcium channel blockers, angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors, diuretics, nitrates, and eplerenone;
**** shock index was calculated as heart rate divided by systolic blood pressure.
GCS – Glasgow coma scale; BP – blood pressure; SpO – oxygen saturation; q-SOFA – quick Sequential Organ Failure Assessment.

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750