UTILIDAD DE LA ESCALA RÁPIDA DE MEDICINA DE EMERGENCIAS COMO UNA HERRAMIENTA PRONÓSTICA DE MORTALIDAD INTRAHOSPITALARIA EN COMPARACIÓN CON LA ESCALA APACHE II EN PACIENTES QUIRÚRGICOS Y NO QUIRÚRGICOS EN URGENCIAS ADULTOS DEL HOSPITAL JUÁREZ DE MÉXICO

Abstract

Objective: Quickly determine the scale of emergency medicine is as effective a method for the prediction of hospital mortality in patients with surgical and nonsurgical diagnoses in adult emergency services at the Hospital Juarez de Mexico. Introduction: The emergency department is the first port of contact for most patients admitted to a hospital, so that the emergency physician must give a prompt diagnosis and treatment of critically ill patients and help give a better quality care and reduce mortality, in addition to classifying severity from admission. The rapid scale of emergency medicine (REMS) is a scale derived from the APACHE II, which has been used to predict hospital mortality of medical patients, is a simple, readily available, can be determined by patient income. Methods: We performed a prospective, observational and comparative study in patients who were hospitalized in the emergency department over 18 years from June 2010 to November 2010, at the Juarez Hospital in Mexico. A total of 400 patients, the scale was applied REMS and APACHE II at admission were followed until discharge or death due to improvement. Results: A total of 400 patients, 181 were women (45.3%) and 219 patients were men (54.8%). Patients were divided into two groups with surgical diagnoses were 95 patients (23.8%) and 305 patients with non-surgical (76.3%). It was observed that there was a strong correlation between the two scales REMS and APACHE II in both groups of patients with surgical diagnosis (Pearson correlation 0.78) and non-surgical diagnosis (Pearson correlation 12 0.68). In the ROC curve of the two scales showed a significant discrimination in the group of patients with surgical (0.80 confidence interval (CI) 0.73 to 0.87 and 0.85 95% confidence interval (CI) 95% 0.79 to 0.91 ) and non-surgical diagnosis group (0.80 confidence interval (CI) 95% 0.73 to 0.87, 0.81 confidence interval (CI) 95% 0.75 to 0.87). The current study revealed that the REMS have a significant prediction of hospital mortality in patients with surgical and nonsurgical diagnosis. Conclusions: Quick scale emergency medicine has a significant prediction of hospital mortality in surgical and nonsurgical patients.