Data from: Routine blood tests are associated with short term mortality and can improve emergency department triage: a cohort study of >12,000 patients

Background: Prioritization of acutely ill patients in the Emergency
Department remains a challenge. We aimed to evaluate whether routine blood
tests can predict mortality in unselected patients in an emergency
department and to compare risk prediction with a formalized triage
algorithm. Methods: A prospective observational cohort study of 12,661
consecutive admissions to the Emergency Department of Nordsjælland
University Hospital during two separate periods in 2010 (primary cohort,
n = 6279) and 2013 (validation cohort, n = 6383). Patients were triaged in
five categories by a formalized triage algorithm. All patients with a full
routine biochemical screening (albumin, creatinine, c-reactive protein,
haemoglobin, lactate dehydrogenase, leukocyte count, potassium, and
sodium) taken at triage were included. Information about vital status was
collected from the Danish Central Office of Civil registration. Multiple
logistic regressions were used to predict 30-day mortality. Validation was
performed by applying the regression models on the 2013 validation cohort.
Results: Thirty-day mortality was 5.3%. The routine blood tests had a
significantly stronger discriminative value on 30-day mortality compared
to the formalized triage (AUC 88.1 [85.7;90.5] vs. 63.4 [59.1;67.5],
p < 0.01). Risk stratification by routine blood tests was able to
identify a larger number of low risk patients (n = 2100, 30-day mortality
0.1% [95% CI 0.0;0.3%]) compared to formalized triage (n = 1591, 2.8% [95%
CI 2.0;3.6%]), p < 0.01. Conclusions: Routine blood tests were
strongly associated with 30-day mortality in acutely ill patients and
discriminatory ability was significantly higher than with a formalized
triage algorithm. Thus routine blood tests allowed an improved risk
stratification of patients presenting in an emergency department.