Abstract
Objective: To determine whether front-door discharge decision tools operate at different mortality thresholds.
Methods: Three databases searched, for studies testing, deriving or validating front-door risk prediction tools or discharge decision aids, with defined discharge 'cut-off', reporting mortality or readmission rates. Studies supporting tools' inclusion in national guidelines were also included.
Results: Twenty-four studies were included, frequently for acute chest pain. Mortality rates among those discharged based on tools 0-1.7%. Eight studies reported readmission rates, 0-8% among those discharged early or deemed low-risk.
Conclusion: Although mortality rates were lower for those deemed low-risk by decision aids than those admitted or control groups, readmission rates tended to be higher among low-risk or discharged patients, than among control group or admitted patients.
Methods: Three databases searched, for studies testing, deriving or validating front-door risk prediction tools or discharge decision aids, with defined discharge 'cut-off', reporting mortality or readmission rates. Studies supporting tools' inclusion in national guidelines were also included.
Results: Twenty-four studies were included, frequently for acute chest pain. Mortality rates among those discharged based on tools 0-1.7%. Eight studies reported readmission rates, 0-8% among those discharged early or deemed low-risk.
Conclusion: Although mortality rates were lower for those deemed low-risk by decision aids than those admitted or control groups, readmission rates tended to be higher among low-risk or discharged patients, than among control group or admitted patients.
Original language | English |
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Pages (from-to) | 152-165 |
Number of pages | 14 |
Journal | Acute Medicine |
Volume | 23 |
Issue number | 3 |
DOIs | |
Publication status | Published - 6 Nov 2024 |
Keywords
- Decision tools
- Front-door
- Early discharge
- Decision support