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ID 119610
Author
Hori, Taiki Tokushima Prefectural Kaifu Hospital|Tokushima University
Kaneko, Yousuke Tokushima Prefectural Kaifu Hospital
Kawata, Saki Tokushima Prefectural Kaifu Hospital
Kawahito, Keisuke Tokushima Prefectural Kaifu Hospital
Kita, Hiroki Tokushima Prefectural Kaifu Hospital
Shimizu, Kazuma Tokushima Prefectural Kaifu Hospital
Hosoki, Minae Tokushima Prefectural Kaifu Hospital
Mori, Kensuke Tokushima Prefectural Kaifu Hospital
Kageji, Teruyoshi Tokushima Prefectural Kaifu Hospital KAKEN Search Researchers
Uraoka, Hideyuki Tokushima Prefectural Kaifu Hospital
Keywords
respiratory adjusted shock index
elderly
emergency room
medical diseases
prognosis
Content Type
Journal Article
Description
Background: The respiratory adjusted shock index (RASI) is a risk score whose usefulness in patients with sepsis and trauma has previously been reported. However, its relevance in elderly emergency patients with medical diseases is yet to be clarified. This study assessed the usefulness of the RASI, which can be evaluated without requiring special equipment, to provide objective and rapid emergency responses. Methods: In this retrospective study, we recruited patients with medical diseases, aged 65 years or older, who were transported to the emergency room from Tokushima Prefectural Kaifu Hospital and underwent arterial blood gas testing from 1 January 2022 to 31 December 2023. We investigated the association of the RASI with other indices, including the lactate level, National Early Warning Score 2 (NEWS2), Shock Index (SI), Sequential Organ Failure Assessment (SOFA) score, quick SOFA (qSOFA) score, and systemic inflammatory response syndrome (SIRS). Results: In this study, we included 260 patients (mean age, 86 years), of whom 234 were admitted to the hospital; 27 and 49 patients died within 7 and 30 days of admission, respectively. The RASI was positively correlated with the lactate level, NEWS2, SI, and increase in the SOFA score (p < 0.001). The RASI was higher in patients with a SIRS or qSOFA score ≥ 2 than in those without (p < 0.001). It predicted death within 7 and 30 days of admission with an area under the curve (AUC) of 0.80 (95% confidence interval [CI]: 0.73–0.87), sensitivity of 96.3%, and specificity of 53.6% when the cutoff value was set to 1.58 and with an AUC of 0.73 (95% CI: 0.66–0.81), sensitivity of 69.4%, and specificity of 70.6% when the cutoff value was set to 1.83, respectively. Conclusions: The RASI is a simple indicator that can be used for predicting in-hospital outcomes in elderly emergency patients with medical diseases. Larger prospective studies based on this study are needed.
Journal Title
Journal of Clinical Medicine
ISSN
20770383
Publisher
MDPI
Volume
13
Issue
16
Start Page
4866
Published Date
2024-08-18
Rights
This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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language
eng
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departments
Medical Sciences
University Hospital