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HOTEL Score of Kellett et al for Predicting Mortality Within 24 Hours of Admission to an Acute Medical Unit of the Hospital

Purpose: To identify a patient likely to die within 24 hours of admission to an acute medical unit using the HOTEL score of Kellett et al.

Description

Kellett et al developed the HOTEL score for identifying a patient with a high mortality rate following admission to an acute medical unit of the hospital. These can help to identify a patient who may benefit from more aggressive management. The authors are from Nenagh Hospital in County Tipperary, Ireland.


Patient selection: 14 years old or older, acutely ill but not moribund (dead within 15 minutes)

 

Outcome: death from 15 minutes to 24 hours after admission

 

Parameters:

H: hypotension

O: oxygen saturation

T: low temperature

E: EEG abnormalities

L: loss of function

 

Parameter

Finding

Points

systolic blood pressure

>= 100 mm Hg

0

 

< 100 mm Hg

1

oxygen saturation

>= 90%

0

 

< 90%

1

body temperature

>= 35°C

0

 

< 35°C

1

EEG

normal

0

 

abnormal

1

loss of function

able to stand unaided

0

 

unable to stand unaided

1

 

HOTEL score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the higher the early mortality rate.

 

Score

Mortality Rate

0

0

1

0.3%

2

1-2%

3 or more

6-10%

 

The authors found that a normal EEG was a "powerful predictor of survival".

 

Sum of HOTEL

EEG

Mortality Rate

0

normal

0%

0

abnormal

0.3%

1

normal

0.3%

1

abnormal

1.2%

2 to 4

normal

1.2%

2 to 4

abnormal

9%

 

Performance:

• The area under the ROC curve was 86.5% for the derivation cohort and 85.4% for the validation cohort.


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Objective

ICD-10