When compared with urine acetoacetate testing, blood β-hydroxybutyrate determination can reduce the need of admission, shorten the duration of hospital admission and potentially reduce the costs of hospital care.
The AEP criteria were designed to identify patients in need of admission.
The PMEWS score performs well for discerning those patients in need of admission (area under ROC curve 0.944) and triages effectively those in need of higher levels of care before irreversible organ dysfunction is established (area under ROC curve 0.83), whereas CURB-65 achieves comparable areas under the ROC curve of only 0.81 and 0.64 respectively.
That is, the time taken to refer, review, admit and transfer patients in need of admission might take more time than the discharge of patients from ED. Efforts to shorten one or more of these time periods would require concerted efforts to involve inpatient teams and could reduce ED LOS.
The nurse and doctor were asked if they found that the patient was in need of admission to a medical department, and was thus asked to make this decision within a few hours after the patient arrived at the department and before any laboratory results were known.
The rationale for using MSCAT given by Angoff and Huddleston was the changing needs of the admission testing process, in which the range of student skills was becoming increasingly broader, while at the same time, the same admission tests were beginning to be used in scholarship programs that demanded top students.
PMEWS was a better predictor of need for admission (AUROC 0.944) and need of higher level of care (AUROC 0.83) compared with CURB-65 (AUROCs 0.881 and 0.640 respectively) but was not as good a predictor of subsequent inpatient mortality (AUROC 0.663).
It forms part of a suite of structured professional judgment instruments [ 16] along with the DUNDRUM-2, an instrument for assessing the urgency of need for admission and prioritisation of waiting lists, and two instruments for assessing readiness for movement to less secure places, the DUNDRUM-3 programme completion instrument and the DUNDRUM-4 recovery instrument.
The first item, which rates the patient's urgency of need for admission based on their current location, takes into account a number of different possible locations a patient may be referred from for example a remand prison, a sentenced prison or a patient in a hospital at a lower level of security than is required or appropriate.
It is designed to assess the urgency of need for admission to a secure forensic hospital.
