Predictability of Adult Patient Medical Emergency Condition from Triage Vital Signs and Comorbidities: A Single-Center, Observational Study

Background Vital signs and comorbid diseases are the first information evaluated in patients admitted to the emergency department (ED). This study aims to assess the relationship between initial vital signs, comorbid diseases, and medical emergency conditions (MEC) in patients admitted to the ED. Methods This prospective study was designed as a single-center observational study, including patients admitted to a tertiary ED between 16.06.2022 and 09.09.2022. Patients younger than 18, readmitted to the ED within 24 hours, or absence of vital signs due to cardiac arrest were excluded from the study. Vital signs and comorbid diseases of all patients were recorded. The mortality within 24 hours, the need for intensive care unit admission, emergency surgery, and life-saving procedures were considered “medical emergency conditions”. The role of vital signs and comorbid diseases in predicting emergencies was analyzed by binary logistic regression. Results A total of 10022 patients were included in the study; 5056 (50.4%) were female, and 4966 (49.6%) were male. The median age of patients was 46 (min-max: 18–104). Six hundred four patients presented with a MEC. 3480 (34.7%) patients had at least one comorbidity, while 5031 (50.2%) patients had at least one abnormal vital sign. Hypoxia (Odd’s Ratio [OR]: 1.73), diastolic hypotension (OR: 3.71), tachypnea (OR: 8.09), and tachycardia (OR: 1.61) were associated with MECs. Hemiplegia (OR: 5.7), leukemia (OR: 4.23), and moderate-severe liver disease (OR: 2.99) were the most associated comorbidities with MECs. In our study, a MEC was detected in 3.6% (186 patients) of the patients with no abnormal vital signs and without any comorbidities. Conclusion Among the vital signs, hypoxia, diastolic hypotension, tachypnea, and tachycardia should be considered indicators of a MEC. Hemiplegia, leukemia, and moderate-severe liver disease are the most relevant comorbidities that may accompany the MECs.