Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction
Abstract The emergency department (ED) plays a crucial role in evaluating patients with decreased general condition (DGC). Prompt diagnosis and precise risk stratification enhances clinical care outcomes. This study aimed to reveal which scoring system is better for predicting mortality in patients...
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Nature Portfolio
2025-04-01
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| Online Access: | https://doi.org/10.1038/s41598-025-97386-5 |
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| author | Emine Aykol Mehmet Cihat Demir Kudret Selki Hasan Sultanoğlu |
| author_facet | Emine Aykol Mehmet Cihat Demir Kudret Selki Hasan Sultanoğlu |
| author_sort | Emine Aykol |
| collection | DOAJ |
| description | Abstract The emergency department (ED) plays a crucial role in evaluating patients with decreased general condition (DGC). Prompt diagnosis and precise risk stratification enhances clinical care outcomes. This study aimed to reveal which scoring system is better for predicting mortality in patients with DGC. This single-center prospective study was conducted between 1 March 2021 and 1 June 2021 in a tertiary university hospital’s ED. All patients presented with DGC were included. The scores assessed upon ED admission for patients include the Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence, abbreviated as HOTEL score, Rapid Emergency Medicine Score (REMS), and the Worthing Physiological Scoring (WPS). The study aimed to compare the scoring systems to identify which is the best mortality predictor. Independent risk factors for 30-day mortality were analyzed using binary logistic regression and ROC curves to assess the effectiveness of HOTEL, REMS, and WPS scores in predicting mortality. The study was conducted with 137 DGC patients. The median age of patients presented to the ED with DGC was 77 (66.5–87), and 50.4% were male. 52.6% of patients died within one month. Analysis of mortality risk factors revealed that gender, age, day of admission, visit type, home oxygen, urinary catheter use, and speech status were not independent risk factors. For one-month mortality prediction, AUCs were: HOTEL 0.644 (cut-off 1), REMS 0.635 (cut-off 8), WPS 0.547 (cut-off 5). For mechanical ventilation: HOTEL 0.689 (10), REMS 0.790 (10), WPS 0.777 (4). For ICU admission: HOTEL 0.697 (2), REMS 0.770 (9), WPS 0.728 (4). Both the HOTEL and REMS scoring systems have moderate prognostic value in predicting mortality in patients with a DGC. The REMS, and WPS scores are also more helpful in determining the need for intensive care unit admission and mechanical ventilation. |
| format | Article |
| id | doaj-art-22b3a9d34e0a45cc8d178c824b884231 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-22b3a9d34e0a45cc8d178c824b8842312025-08-20T03:10:14ZengNature PortfolioScientific Reports2045-23222025-04-011511910.1038/s41598-025-97386-5Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality predictionEmine Aykol0Mehmet Cihat Demir1Kudret Selki2Hasan Sultanoğlu3Department of Emergency Medicine, School of Medicine, Düzce UniversityDepartment of Emergency Medicine, School of Medicine, Düzce UniversityDepartment of Emergency Medicine, School of Medicine, Düzce UniversityDepartment of Emergency Medicine, School of Medicine, Düzce UniversityAbstract The emergency department (ED) plays a crucial role in evaluating patients with decreased general condition (DGC). Prompt diagnosis and precise risk stratification enhances clinical care outcomes. This study aimed to reveal which scoring system is better for predicting mortality in patients with DGC. This single-center prospective study was conducted between 1 March 2021 and 1 June 2021 in a tertiary university hospital’s ED. All patients presented with DGC were included. The scores assessed upon ED admission for patients include the Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence, abbreviated as HOTEL score, Rapid Emergency Medicine Score (REMS), and the Worthing Physiological Scoring (WPS). The study aimed to compare the scoring systems to identify which is the best mortality predictor. Independent risk factors for 30-day mortality were analyzed using binary logistic regression and ROC curves to assess the effectiveness of HOTEL, REMS, and WPS scores in predicting mortality. The study was conducted with 137 DGC patients. The median age of patients presented to the ED with DGC was 77 (66.5–87), and 50.4% were male. 52.6% of patients died within one month. Analysis of mortality risk factors revealed that gender, age, day of admission, visit type, home oxygen, urinary catheter use, and speech status were not independent risk factors. For one-month mortality prediction, AUCs were: HOTEL 0.644 (cut-off 1), REMS 0.635 (cut-off 8), WPS 0.547 (cut-off 5). For mechanical ventilation: HOTEL 0.689 (10), REMS 0.790 (10), WPS 0.777 (4). For ICU admission: HOTEL 0.697 (2), REMS 0.770 (9), WPS 0.728 (4). Both the HOTEL and REMS scoring systems have moderate prognostic value in predicting mortality in patients with a DGC. The REMS, and WPS scores are also more helpful in determining the need for intensive care unit admission and mechanical ventilation.https://doi.org/10.1038/s41598-025-97386-5Decreased general conditionEmergency departmentMortalityHOTELWPSREMS |
| spellingShingle | Emine Aykol Mehmet Cihat Demir Kudret Selki Hasan Sultanoğlu Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction Scientific Reports Decreased general condition Emergency department Mortality HOTEL WPS REMS |
| title | Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction |
| title_full | Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction |
| title_fullStr | Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction |
| title_full_unstemmed | Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction |
| title_short | Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction |
| title_sort | evaluation of patients with decreased general condition and comparing hotel wps and rems for mortality prediction |
| topic | Decreased general condition Emergency department Mortality HOTEL WPS REMS |
| url | https://doi.org/10.1038/s41598-025-97386-5 |
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