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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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
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spelling A transfer triage tool for COVID-19 mass critical care surgesAzeli, YoucefSolà-Muñoz, SilviaTrenado Álvarez, JoséJacob, JavierCubedo Culleré, MartaDelgado, RicardoMugica, Edurne MirenFontan, IraitzBracero, AntonioLópez-López, CristinaCarricondo-Avivar, Maria del MarLuque-Hernández, María JoséVillalba, EloySimón, SilviaCastejón de la Encina, María ElenaGoñi, CristinaCardenete, CésarQuintela, ZitaAbejón, RaquelBermejo, ÁngelMartín, MarioSoto-García, Maria ÁngelesMorales-Alvarez, JorgeCuartas-Alvarez, TatianaCastro-Delgado, RafaelJiménez i Fàbrega, XavierServeis d'urgències mèdiquesTriatge (Medicina)COVID-19Salut públicaEmergency medical servicesTriage (Medicine)COVID-19Public healthThe 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.Nature Publishing Group2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/220935Articles publicats en revistes (Genètica, Microbiologia i Estadística)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1038/s41598-025-95337-8Scientific Reports, 2025, vol. 15, p. 1-9https://doi.org/10.1038/s41598-025-95337-8cc-by-nc-nd (c) Azeli, Youcef et al., 2025https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2209352026-05-27T06:46:51Z
dc.title.none.fl_str_mv A transfer triage tool for COVID-19 mass critical care surges
title A transfer triage tool for COVID-19 mass critical care surges
spellingShingle A transfer triage tool for COVID-19 mass critical care surges
Azeli, Youcef
Serveis d'urgències mèdiques
Triatge (Medicina)
COVID-19
Salut pública
Emergency medical services
Triage (Medicine)
COVID-19
Public health
title_short A transfer triage tool for COVID-19 mass critical care surges
title_full A transfer triage tool for COVID-19 mass critical care surges
title_fullStr A transfer triage tool for COVID-19 mass critical care surges
title_full_unstemmed A transfer triage tool for COVID-19 mass critical care surges
title_sort A transfer triage tool for COVID-19 mass critical care surges
dc.creator.none.fl_str_mv 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
author Azeli, Youcef
author_facet 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
author_role author
author2 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
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Serveis d'urgències mèdiques
Triatge (Medicina)
COVID-19
Salut pública
Emergency medical services
Triage (Medicine)
COVID-19
Public health
topic Serveis d'urgències mèdiques
Triatge (Medicina)
COVID-19
Salut pública
Emergency medical services
Triage (Medicine)
COVID-19
Public health
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/220935
url https://hdl.handle.net/2445/220935
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1038/s41598-025-95337-8
Scientific Reports, 2025, vol. 15, p. 1-9
https://doi.org/10.1038/s41598-025-95337-8
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Azeli, Youcef et al., 2025
https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Azeli, Youcef et al., 2025
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Nature Publishing Group
publisher.none.fl_str_mv Nature Publishing Group
dc.source.none.fl_str_mv Articles publicats en revistes (Genètica, Microbiologia i Estadística)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812455

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