Can we predict mortality in the emergency department?

Published:December 18, 2019DOI:
      Conway et al. performed a retrospective study using administrative data to assess the utility of two parameters to predict 30-day mortality during an emergency department (ED) visit [

      Conway R., Byrne D., O'Riordan D., Silke B. Comparative influence of acute illness severity and comorbidity on mortality. In Press, In This Issue 2019.

      ]. They evaluated the potential prognostic roles of a newly developed Comorbidity Index that assess patient comorbidities, and an Acute Illness Severity Score (AISS) that quantifies the severity of the present illness. The authors stratified mortality risk, and correlated the severity of the acute disease and the comorbidity burden to clinical outcomes. For example, a patient with pneumonia and severe respiratory failure but no comorbidities might have a mortality risk similar to that of a patient with a mild pneumonia and a complicated medical history. They highlighted an insight of every physician who works in the clinical setting: clinical outcome is not determined entirely by the acute illness, but is also influenced by the patient's frailty. In addition, they found that higher AISS values were associated with lower prognostic accuracy of the comorbidity index for the prediction of mortality.
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