Background Medical emergency teams (METs) have been implemented to reduce hospital mortality by the early recognition and treatment of potentially life-threatening conditions. The objective of this study was to establish a clinically useful association between clinical variables and mortality risk, among patients assessed by the MET, and further to design an easy-to-use risk score for the prediction of death within 30 days. Methods Observational retrospective register study in a tertiary university hospital in Sweden, comprising 2,601 patients, assessed by the MET from 2010 to 2015. Patient registry data at the time of MET assessment was analysed from an epidemiological perspective, using univariable and multivariable analyses with death within 30 days as the outcome variable. Predictors of outcome were defined from age, gender, type of ward for admittance, previous medical history, acute medical condition, vital parameters and laboratory biomarkers. Identified factors independently associated with mortality were then used to develop a prognostic risk score for mortality. Results The overall 30-day mortality was high (29.0%). We identified thirteen factors independently associated with 30-day mortality concerning; age, type of ward for admittance, vital parameters, laboratory biomarkers, previous medical history and acute medical condition. A MET risk score for mortality based on the impact of these individual thirteen factors in the model yielded a median (range) AUC of 0.780 (0.774–0.785) with good calibration. When corrected for optimism by internal validation, the score yielded a median (range) AUC of 0.768 (0.762–0.773). Conclusions Among clinical variables available at the time of MET assessment, thirteen factors were found to be independently associated with 30-day mortality. By applying a simple risk scoring system based on these individual factors, patients at higher risk of dying within 30 days after the MET assessment may be identified and treated earlier in the process.

Background: Medical emergency teams (METs) have been implemented to reduce hospital mortality by the early recognition and treatment of potentially life-threatening conditions. The objective of this study was to establish a clinically useful association between clinical variables and mortality risk, among patients assessed by the MET, and further to design an easy to use risk score for prediction of death within 30 days. Methods: Observational retrospective register study in a tertiary university hospital in Sweden, comprising 2,601 patients, assessed by the MET from 2010 to 2015. Patient registry data at the time of MET assessment was analysed from an epidemiological perspective, using univariable and multivariable analyses with death within 30 days as endpoint. Identified factors independently associated with mortality were then used to develop a prognostic risk score for mortality. Results: The overall 30-day mortality was high (29.0%). We identified thirteen factors independently associated with 30-day mortality concerning; age, type of ward for admittance, vital parameters, biomarkers, previous medical history and acute medical condition. A MET risk score for mortality based on the impact of these individual thirteen factors in the model yielded a median (range) AUC of 0.780 (0.774-0.785) with good calibration. When corrected for optimism by internal validation, the score yielded a median (range) AUC of 0.768 (0.762-0.773). Conclusions: Among clinical variables available at the time of MET assessment, thirteen factors were found to be independently associated with 30-day mortality. By applying a simple risk scoring system based on these individual factors, patients at higher risk of dying within 30 days after the MET assessment may be identified and treated earlier in the process. Trial registration: Retrospectively registered.

Background: Medical emergency teams (METs) have been implemented to respond more efficiently to inpatient crises in order to reduce hospital mortality by the early recognition and treatment of potentially life-threatening conditions. The objective of this study was to identify factors associated with 30-day mortality risk among patients assessed by the MET.Methods: Observational retrospective register study in a tertiary university hospital in Sweden, comprising 2,601 patients, assessed by the MET from 2010 to 2015. Patient registry data at the time of MET assessment was analysed from an epidemiological perspective, using univariable and multivariable analyses with death within 30 days as the endpoint.Results: The overall 30-day mortality was high (29.0%) and almost twice as high on medical wards as on surgical wards (37.1% vs 19.8%). The acute medical conditions associated with the highest 30-day mortality were gastroenteritis (50.0%), acute coronary syndrome (43.0%), cardiac failure (41.1%) and renal failure (40.4%). The multivariable analysis indicated that factors with increased 30-day mortality were reflected in age, type of ward, vital parameters, laboratory findings, previous medical history and acute medical condition. Apart from age, the factor associated with the highest odds ratio for 30-day mortality was hypoglycaemia (OR 4.30 (95% CI 2.10, 8.81)).Conclusions: We found that factors reflecting the patients' age, co-morbidity and acute medical condition, along with clinical findings such as vital parameters and laboratory abnormalities, and also the type of ward for admittance, all contributed to identifying patients at risk of death within 30 days after MET assessment. Overall, medical ward patients have higher 30-day mortality than surgical ward patients. Abnormalities in vital parameters reflecting respiratory distress appeared to be more alarming than waning circulatory functions.