Predictive Value of the Rapid Emergency Medicine Score (REMS) for Non-trauma Geriatric Patients Presenting to the...

In the future, countries such as India are expected to experience an increase in the number of elderly patients with medical conditions in the emergency department (ED) due to demographic changes. Increased mortality, institutionalization, hospital readmission, and functional impairment are some of the potentially severe outcomes associated with hospitalization for some of these older patients. Through this study, we aimed to evaluate the utility of the Rapid Emergency Medicine Score (REMS) in predicting morbidity and in-hospital mortality among geriatric patients presenting to the ED.

A prospective observational study was conducted in the Department of Emergency Medicine from November 2020 to March 2022. The data were retrieved from the records of patients who presented to the ED. After obtaining the necessary clearance from the hospital's ethical review committee, follow-up data were subsequently collected from the in-patient records of these patients.

REMS demonstrated a sensitivity of 50.57% and a specificity of 77.88% for predicting intensive care unit (ICU) admissions. The calculated area under the curve (AUC) for REMS in this study was 0.68, with a confidence interval of 0.60-0.75. We also compared the AUC of both REMS and modified Rapid Emergency Medicine Score (mREMS), and no difference was found between the two scores. As per the results, the REMS score predicted morbidity and mortality in geriatric patients presenting to the ED with low sensitivity and equivocal specificity.

REMS is a relatively reliable predictor of the likelihood of admission, particularly for ICU admissions, and a moderately effective predictor for admitting patients to the ward with a sensitivity of 50%.