RT Journal Article
SR Electronic
T1 Prediction of admission to a low-resource sub-Saharan hospital by mental status, mobility and oxygen saturation recorded on arrival: a prospective observational study
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP e639
OP e644
DO 10.7861/clinmed.2021-0325
VO 21
IS 6
A1 Brian Kikomeko
A1 George Mutiibwa
A1 Pauline Nabatanzi
A1 Alfred Lumala
A1 John Kellett
A1 on behalf of the Kitovu Hospital Study Group
YR 2021
UL http://www.rcpjournals.org/content/21/6/e639.abstract
AB Background The decision to admit patients to hospital in low-resource settings have been poorly investigated.Aim We aimed to determine the association of a disposition score determined on arrival with the decision subsequently made to admit or discharge the patient. The score awarded one point for altered mental status, one point for impaired mobility and one point for low oxygen saturation.Methods The mental status, mobility and oxygen saturation on arrival of 5,334 consecutive patients attending a combined emergency and outpatient department in a low-resource Ugandan hospital were recorded. Admission decisions were subsequently made independently by clinicians unaware to the score.Results Most patients (n=3,876; 73%) had a disposition score of zero and only 25 of these patients (0.6%) were subsequently admitted. A total of 646 (12.1%) patients were admitted. Only 301 (5.6%) patients had a score of 3 points and 263 (87.4%) of these were admitted. The C statistic for the discrimination of the score for admission was 0.953 (95% confidence interval 0.941–0.964).Conclusion In a low-resource setting, a simple score based on mental status, mobility and oxygen saturation identified outpatient and emergency department patients most and least likely to be subsequently admitted to hospital with a high degree of discrimination.