COMBINATION OF LACTATE WITH MODIFIED EARLY WARNING SCORE AND RAPID EMERGENCY MEDICINE SCORE IN GERIATRIC PATIENTS ADMITTED TO EMERGENCY DEPARTMENT TO PREDICT 28-DAY MORTALITY

Introduction: Aim was to compare the efficacy of Rapid Emergency Medicine Score, Rapid Emergency Medicine Score-Lactate, Modified Early Warning Score and Modified Early Warning Score-Lactate scores in predicting 28-day mortality after emergency department visit and hospitalization from emergency department for patients with age >= 65 years. Materials and Method: The prospective observational study that carried out between February 29 to April 30, 2016 included patients with age >= 65 years who were referred to emergency department and did not have any trauma history. Results: The mean age of 1106 patients included was 77.23 +/- 7.41 years and 52.3% (n=578) were female. In the prediction of hospital admission, AUC for Rapid Emergency Medicine Score, Rapid Emergency Medicine Score-Lactate, Modified Early Warning Score and Modified Early Warning Score-Lactate were 0.837, 0.918, 0.817, 0.927 (p=0.001, p<0.001, p=0.002, p<0.001) respectively. In the prediction of 28-day mortality AUC for Rapid Emergency Medicine Score, Rapid Emergency Medicine Score-Lactate, Modified Early Warning Score and Modified Early Warning Score-Lactate were 0.659, 0.695, 0.647, 0.681 (p<0.001, p<0.001, p<0.001, p<0.001) respectively. Conclusion: Rapid Emergency Medicine Score and Modified Early Warning Score were powerful in predicting hospital admission from emergency department and had moderate force in predicting 28-day mortality. Rapid Emergency Medicine Score-Lactate and Modified Early Warning Score-Lactate scoring systems are more powerful than isolated Rapid Emergency Medicine Score and Modified Early Warning Score in predicting both for hospitalization and 28-day mortality.