Using a simplified pre-hospital ' MET' score to predict in-hospital care and outcomes.

Background Medical emergency team ( MET) activation criteria serve as a predictor of serious adverse events on hospital wards and in the emergency department ( ED). We aimed to determine whether in-hospital MET activation criteria would be useful in identifying patients at risk in pre-hospital care. Methods The data were collected retrospectively from 610 adult patients treated by physician-staffed helicopter emergency medical services. Pre-hospital vital signs were compared with MET activation criteria and scored accordingly to receive a simplified pre-hospital ' MET' score. The primary outcome measure was hospital mortality. The secondary outcome measures were admission to intensive care unit and the length of ED stay, intensive care unit ( ICU) stay and hospital stay. The simplified pre-hospital ' MET' score was also compared with Emergency Severity Index ( ESI) used as a triage tool in ED. Results Higher simplified pre-hospital ' MET' scores were associated with hospital mortality ( P < 0.001), the need for ICU treatment ( P < 0.001) and a more urgent ESI class in the ED ( P < 0.001). Higher simplified pre-hospital ' MET' scores were associated with shorter stay in the ED ( P < 0.001), longer stay in the ICU ( P < 0.001) and longer hospital stay ( P < 0.001). A simplified pre-hospital ' MET' score was an independent predictor for hospital mortality (odds ratio 2.42, confidence interval 1.84 3.18, P < 0.001), regardless of age or patient's previous overall physical health classified by American Society of Anesthesiologists physical status classification system. Conclusion A simplified pre-hospital ' MET' score is a predictor for patient outcome and could serve as a risk assessment tool for the health care provider on-scene. [ABSTRACT FROM AUTHOR]