Category:ALERT Scale

Medical Outcome Strafitication and Triage" (MOST).

A locally tested and validated risk stratification assessment score which is made at the time that a Medicine Service Physician accepts a patient to the Medicine Service.

• Started January 1, 2007.

Use of MOST score

• The MOST score is a risk stratification tool that generates a probability of an adverse outcome for a patient. The early stratification of medical patients for subsequent risk of an adverse outcome may have potential benefits for determining the type of care environment to which a patient should initially be admitted. (ICU, step-up unit etc.).

• adverse outcomes:
  • Hospital mortality (death) within 30 days of admission
  • cardiac arrest within 30 days of admission
  • transfer to ICU within 48 hours of ward admission
    • (palliative care clients or those with unknown outcomes are excluded. Unknown outcomes are those patients who are discharged to non medicine service in the hospital within 30 days and are unable to be tracked in the database.

• the MOST score was validated on data collected at HSC, SBGH, the Grace and Victoria hospital on over 11,000 patients admitted to medical units in 2004/2005.
• MOST score is based on the FIRST ward admission during a hospital stay.
• There is no existing tool that can make such prediction for non ICU patients. This makes this equation and the research conducted by Dr. Roberts and Julie Mojica with the support of the data collection team extremely valuable.

Elements of MOST score

1. Charlson Comorbids (CCI) Comorbid Diagnosis
2. Age (Date of Birth)
3. Sex
4. Katz - Activities of Daily Living (ADL)

Physiological variable:

• 1. Glasgow Coma Scale (GSC)
  2. AP Sys BP Field (SBP)
  3. Respiratory Rate ( RR)
  4. Heart Rate ( HR)
  5. White Blood Count ( WBC)

The timing of MOST score assessment

1. When a patient is admitted FROM the EMERGENCY DEPT, the MOST assessment is done using values closest to the time that the “decision to accept to medicine service” was made.
2. When patients move BETWEEN WARDS or FROM an ICU to a medicine ward the MOST assessment is made using values from the closest time of discharge from the sending service.

• *Dr. Dan Roberts

TOstryzniuk 20:35, 24 November 2008 (CST) Template:Stub