A transfer triage tool for COVID-19 mass critical care surges

The objective of this study is to develop and validate a predictive model for mortality among severe COVID-19 patients who are candidates for inter-hospital transfer. A multicenter prospective observational study was conducted between 1 January 2021 and 30 April 2021 (third and fourth pandemic waves...

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Detalles Bibliográficos
Autores: Azeli, Youcef, Solà-Muñoz, Silvia, Trenado Álvarez, José, Jacob, Javier, Cubedo Culleré, Marta, Delgado, Ricardo, Mugica, Edurne Miren, Fontan, Iraitz, Bracero, Antonio, López-López, Cristina, Carricondo-Avivar, Maria del Mar, Luque-Hernández, María José, Villalba, Eloy, Simón, Silvia, Castejón de la Encina, María Elena, Goñi, Cristina, Cardenete, César, Quintela, Zita, Abejón, Raquel, Bermejo, Ángel, Martín, Mario, Soto-García, Maria Ángeles, Morales-Alvarez, Jorge, Cuartas-Alvarez, Tatiana, Castro-Delgado, Rafael, Jiménez i Fàbrega, Xavier
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/220935
Acceso en línea:https://hdl.handle.net/2445/220935
Access Level:acceso abierto
Palabra clave:Serveis d'urgències mèdiques
Triatge (Medicina)
COVID-19
Salut pública
Emergency medical services
Triage (Medicine)
Public health
Descripción
Sumario:The objective of this study is to develop and validate a predictive model for mortality among severe COVID-19 patients who are candidates for inter-hospital transfer. A multicenter prospective observational study was conducted between 1 January 2021 and 30 April 2021 (third and fourth pandemic waves) in regional coordination centers of the Emergency Medical Services of eight Spanish autonomous communities. Hospitalized patients with severe COVID-19 transferred to other hospitals were included. Clinical variables from the initial evaluation, the triage score, and in-hospital mortality rates were collected. A Lasso-type regression analysis was performed to fit the mortality predictive model and its performance was evaluated by a leave-one-out cross-validation. Subsequently, the regional mass triage (MATER) score was created. 1,018 transferred patients were included, with a mean age of 62.3 years (SD 12), of whom 65.1% were male and 89.6% were admitted to an Intensive Care Unit. In-hospital mortality was 23.0%. The MATER score included six variables and presented good discrimination ability with an area under the curve of 0.79 (95% CI 0.77–0.81) and a good calibration with a Brier score of 0.135. The MATER score successfully predicted the mortality rate of severe COVID-19 patients and can be helpful in decision-making for triage and transfer prioritization in mass critical care surges.

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