%0 Journal Article
%T Evaluation of an algorithm for estimating a patient's life threat risk from an ambulance call
%A Kenji Ohshige
%A Chihiro Kawakami
%A Shunsaku Mizushima
%A Yoshihiro Moriwaki
%A Noriyuki Suzuki
%J BMC Emergency Medicine
%D 2009
%I BioMed Central
%R 10.1186/1471-227x-9-21
%X Data collected for six months from the Yokohama new emergency system was used. In the system, emergency call workers interviewed ambulance callers to obtain information necessary to assess triage, which included consciousness level, breathing status, walking ability, position, and complexion. An emergency patient's life threat risk was then estimated by a computer algorithm applying logistic models. This study compared the estimated life threat risk occurring at the time of the emergency call to the patients' state or severity of condition, i.e. death confirmed at the scene by ambulance crews, resulted in death at emergency departments, life-threatening condition with occurrence of cardiac and/or pulmonary arrest (CPA), life-threatening condition without CPA, serious but not life-threatening condition, moderate condition, and mild condition. The sensitivity, specificity, predictive values, and likelihood ratios of the algorithm for categorizing A+ were calculated.The number of emergency dispatches over the six months was 73,992. Triage assessment was conducted for 68,692 of these calls. The study targets account for 88.8% of patients who were involved in triage calls. There were 2,349 cases where the patient had died or had suffered CPA. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of the algorithm at predicting cases that would result in a death or CPA were 80.2% (95% confidence interval: 78.6% - 81.8%), 96.0% (95.8% - 96.1%), 42.6% (41.1% - 44.0%), 99.2% (99.2% - 99.3%), 19.9 (18.8 - 21.1), and 0.21 (0.19 - 0.22), respectively.A patient's life threat risk was quantitatively assessed at the moment of the emergency call with a moderate level of accuracy.The demand for emergency medical services is increasing in industrialized countries [1-5]. In many countries, ambulance responses are tailored to give priority to true emergency calls and thus save the lives of patients suf
%U http://www.biomedcentral.com/1471-227X/9/21