This is a summary, written by members of the CITF Secretariat, of:
Brooks SC, Rosychuk RJ, Perry JJ, Morrison LJ, Wiemer H, Fok P, Rowe BH, Daoust R, Vatanpour S, Turner J, Landes M, Ohle R, Hayward J, Scheuermeyer F, Welsford M, Hohl C, the Canadian COVID-19 Rapid Response Network (CCEDRRN) for the Network of Canadian Emergency Researchers (NCER) and the Canadian Critical Care Trials Group (CCCTG). Derivation and validation of a clinical decision rule to risk-stratify COVID-19 patients discharged from the emergency department: The CCEDRRN COVID discharge score. JACEP Open. 2022; 3:e12868. doi: https://doi.org/10.1002/emp2.12868.
The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.
A CITF-funded study published in JACEP Open, showed that the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) COVID discharge score can identify patients at risk of hospital admission or death within 72 hours of emergency department discharge. This study was led by Dr. Corinne Hohl (University of British Columbia).
- Among patients with a CCEDRRN COVID discharge scorePatients are given a score that ranges from 0 to 12. The sum of each of the variables: age, sex, temperature, arrival mode (ambulance/police versus self), pregnancy, respiratory distress, and arrival respiratory rate is used to derive the total CCEDRRN COVID discharge score. Points are allocated within each variable. For age, more points are allocated as age increases. Details of the points allocated for each variable are found in the paper. of 3 or less, the risk for a subsequent hospital admission/in-hospital death, within 72 hours of being discharged from the emergency room – was low (1.9% or less). The sensitivityThe ability of a test to correctly classify an individual as being at risk for hospital admission/in-hospital death of using 3 as a rule-out score was 89.3%.
- Among those with a score of ≥9, the risk for hospital admission/in-hospital death was as high as 12.2% and the specificityThe ability of a test to correctly classify an individual as not being at risk for hospital admission/in-hospital death of using 9 as a rule-in score was 95.6%.
Based on this retrospective observational study, researchers concluded that the CCEDRRN COVID-19 discharge score can accurately identify patients at risk of short-term adverse outcomes after emergency department discharge. Of 15,305 eligible patient visits, 535 (3.6%) experienced death or hospital admission within 72 hours of discharge. Data was obtained from 49 sites in the CCEDRRN between March 1, 2020, and September 8, 2021. Hospitals were randomly assigned to derivation or validation cohorts.