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Sci Rep . A transfer triage tool for COVID-19 mass critical care surges

tetano

Editor, Senior Moderator
Sci Rep


. 2025 Apr 5;15(1):11726.
doi: 10.1038/s41598-025-95337-8. A transfer triage tool for COVID-19 mass critical care surges

Youcef Azeli[SUP] #[/SUP][SUP] 1 2 3 4 [/SUP], Silvia Solà-Muñoz[SUP] #[/SUP][SUP] 5 6 [/SUP], José Trenado[SUP] 5 7 8 [/SUP], Javier Jacob[SUP] 7 9 [/SUP], Marta Cubedo[SUP] 10 [/SUP], Ricardo Delgado[SUP] 6 11 [/SUP], Edurne Miren Mugica[SUP] 6 12 [/SUP], Iraitz Fontan[SUP] 6 12 [/SUP], Antonio Bracero[SUP] 6 13 [/SUP], Cristina López-López[SUP] 6 14 [/SUP], Maria Del Mar Carricondo-Avivar[SUP] 6 14 [/SUP], María José Luque-Hernández[SUP] 6 14 [/SUP], Eloy Villalba[SUP] 6 15 [/SUP], Silvia Simón[SUP] 6 16 [/SUP], María Elena Castejón[SUP] 6 17 [/SUP], Cristina Goñi[SUP] 6 18 [/SUP], César Cardenete[SUP] 6 19 [/SUP], Zita Quintela[SUP] 6 19 [/SUP], Raquel Abejón[SUP] 6 19 [/SUP], Ángel Bermejo[SUP] 6 19 [/SUP], Mario Martín[SUP] 6 19 [/SUP], Maria Ángeles Soto-García[SUP] 5 [/SUP], Jorge Morales-Alvarez[SUP] 5 [/SUP], Tatiana Cuartas-Alvarez[SUP] 6 20 [/SUP], Rafael Castro-Delgado[SUP] 6 20 21 [/SUP], Xavier Jiménez-Fàbrega[SUP] 5 6 7 [/SUP]



Affiliations
Abstract

The objective of this study is to develop and validate a predictive model for mortality among severe COVID-19 patients who are candidates for inter-hospital transfer. A multicenter prospective observational study was conducted between 1 January 2021 and 30 April 2021 (third and fourth pandemic waves) in regional coordination centers of the Emergency Medical Services of eight Spanish autonomous communities. Hospitalized patients with severe COVID-19 transferred to other hospitals were included. Clinical variables from the initial evaluation, the triage score, and in-hospital mortality rates were collected. A Lasso-type regression analysis was performed to fit the mortality predictive model and its performance was evaluated by a leave-one-out cross-validation. Subsequently, the regional mass triage (MATER) score was created. 1,018 transferred patients were included, with a mean age of 62.3 years (SD 12), of whom 65.1% were male and 89.6% were admitted to an Intensive Care Unit. In-hospital mortality was 23.0%. The MATER score included six variables and presented good discrimination ability with an area under the curve of 0.79 (95% CI 0.77-0.81) and a good calibration with a Brier score of 0.135. The MATER score successfully predicted the mortality rate of severe COVID-19 patients and can be helpful in decision-making for triage and transfer prioritization in mass critical care surges.

Keywords: COVID-19; Emergency medical services; Emergency preparedness; Public health; Triage.

 
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