RT Journal Article
SR Electronic
T1 Multicentre, prospective observational study of the correlation between the Glasgow Admission Prediction Score and adverse outcomes
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e026599
DO 10.1136/bmjopen-2018-026599
VO 9
IS 8
A1 Dominic Jones
A1 Allan Cameron
A1 David J Lowe
A1 Suzanne M Mason
A1 Colin A O'Keeffe
A1 Eilidh Logan
YR 2019
UL http://bmjopen.bmj.com/content/9/8/e026599.abstract
AB Objectives To assess whether the Glasgow Admission Prediction Score (GAPS) is correlated with hospital length of stay, 6-month hospital readmission and 6-month all-cause mortality. This study represents a 6-month follow-up of patients who were included in an external validation of the GAPS’ ability to predict admission at the point of triage.Setting Sampling was conducted between February and May 2016 at two separate emergency departments (EDs) in Sheffield and Glasgow.Participants Data were collected prospectively at triage for consecutive adult patients who presented to the ED within sampling times. Any patients who avoided formal triage were excluded from the study. In total, 1420 patients were recruited.Primary outcomes GAPS was calculated following triage and did not influence patient management. Length of hospital stay, hospital readmission and mortality against GAPS were modelled using survival analysis at 6 months.Results Of the 1420 patients recruited, 39.6% of these patients were initially admitted to hospital. At 6 months, 30.6% of patients had been readmitted and 5.6% of patients had died. For those admitted at first presentation, the chance of being discharged fell by 4.3% (95% CI 3.2% to 5.3%) per GAPS point increase. Cox regression indicated a 9.2% (95% CI 7.3% to 11.1%) increase in the chance of 6-month hospital readmission per point increase in GAPS. An association between GAPS and 6-month mortality was demonstrated, with a hazard increase of 9.0% (95% CI 6.9% to 11.2%) for every point increase in GAPS.Conclusion A higher GAPS is associated with increased hospital length of stay, 6-month hospital readmission and 6-month all-cause mortality. While GAPS’s primary application may be to predict admission and support clinical decision making, GAPS may provide valuable insight into inpatient resource allocation and bed planning.