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Scoring System Can Predict Hospital Admissions

Last Updated: June 15, 2009.

The Philadelphia EMS Admission Rule weighted scoring system can reasonably predict whether a patient being transported to the hospital will be admitted, according to a study published in the June issue of Academic Emergency Medicine.

MONDAY, June 15 (HealthDay News) -- The Philadelphia EMS Admission Rule (PEAR) weighted scoring system can reasonably predict whether a patient being transported to the hospital will be admitted, according to a study published in the June issue of Academic Emergency Medicine.

Zachary F. Meisel, M.D., from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues looked at 1,500 randomly selected ambulance transports of adult patients to six different emergency departments in different health systems over a one-year period to test the validity of the previously devised PEAR scoring system. The PEAR system uses weighted components to arrive at a score in a zero to 14 range. Components include chest pain, shortness of breath, dizziness, age ≥60 years, weakness, fainting, along with cancer and diabetes history. The researchers calculated admission rates and PEAR scores and compared actual and predicted admissions.

The researchers found that, of the 1,102 patients included in the analysis, the admission rate was 40 percent, while individual hospital admission rates ranged from 28 to 57 percent. Overall, 34 percent of patients scored ≥4, and 29 percent scored ≥5. The admission rate among patients with a score ≥4 was 77 percent, and among patients with a score ≥5 the admission rate was 80 percent, the authors note.

"The ability of this EMS rule to predict the likelihood of hospital admission appears valid in this multicenter cohort. Further studies are needed to measure the impact and feasibility of using this rule to guide decision-making," Meisel and colleagues conclude.

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