Utility of the Rapid Emergency Medicine Score (REMS) for Predicting Hospital Mortality in Severely Injured Patients.
- Author:
Sang Hoon LEE
1
;
Joon Min PARK
;
Jun Seok PARK
;
Kyung Hwan KIM
;
Dong Wun SHIN
;
Woo Chan JEON
;
Hyun Jong KIM
;
Hoon KIM
Author Information
1. Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Gyeonggido, Korea. aero7@hanmail.net
- Publication Type:Original Article
- Keywords:
Trauma severity indices;
Triage;
Wounds and injuries;
Mortality
- MeSH:
Asphyxia;
Burns;
Drowning;
Emergencies*;
Emergency Medicine*;
Hospital Mortality*;
Hospitalization;
Humans;
Injury Severity Score;
Mortality;
Odds Ratio;
Prognosis;
Prospective Studies;
Referral and Consultation;
ROC Curve;
Trauma Centers;
Trauma Severity Indices;
Triage;
Wounds and Injuries
- From:Journal of the Korean Society of Emergency Medicine
2016;27(2):199-205
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We evaluated the power of the Rapid Emergency Medicine Score (REMS) for predicting hospital mortality in trauma patients. Then, we compared the REMS with two other scoring systems, the Emergency Trauma Score (EMTRAS) and the Injury Severity Score (ISS) for predicting prognosis. METHODS: We examined data from a prospectively collected registry in a single trauma center from January 2010 to November 2011. Patients enrolled in the registry were trauma patients who were predicted to have an ISS>15 or who required urgent multiple surgical consultations as soon as possible. Pediatric patients (<18-years-old) who were referred after initial care or death on arrival, and those with injuries due to burns, asphyxia, or drowning were excluded. The study population was divided into two subgroups according to hospital mortality, and the differences in clinical characteristics and calculated scores were examined. The odds ratio (OR) of REMS for predicting In-hospital mortality was calculated and the prognostic power of the three scoring systems for predicting hospital mortality by drawing receiver operating characteristic (ROC) curves was compared. RESULTS: A total of 103 patients were included in the analysis. Of these, 44 died during hospitalization. All three prognostic scores were significantly higher in the hospital mortality subgroup. The OR of the REMS for predicting hospital mortality was 1.35 (p<0.001). The areas under the ROC curves of the REMS, EMTRAS, and ISS were 0.815 (95% confidence interval [CI], 0.727-0.884), 0.872 (95% CI, 0.793-0.930), and 0.693 (95% CI, 0.595-0.780), respectively. The area under the ROC curve of the REMS was not different from that of the EMTRAS or ISS. CONCLUSION: The REMS showed good prognostic power for predicting hospital mortality in severely injured patients. Consecutive prospective studies are warranted to determine the utility of this scoring system for trauma patients.
