Performance of the PATHOS score in predicting in-hospital mortality in patients aged 65 years and older admitted to the intensive care unit from the emergency department

Purpose: The aim of this study was to investigate the performance of the platelets, age, troponin, heart rate, oxygenation, and systolic blood pressure (PATHOS) score in predicting in-hospital mortality among patients aged 65 years and older admitted to the intensive care unit (ICU) from the emergency department (ED). Materials and Methods: This single-center, retrospective observational study included patients aged 65 years and older who presented to the ED and were admitted to the ICU between 2018 and 2024. The PATHOS score was calculated using routine vital signs and blood parameters obtained at ED admission. The patients were divided into two groups: survivors and non-survivors. The predictive power of the PATHOS score for in-hospital mortality was evaluated by comparing these groups. Results: The study included a total of 1,131 patients. The number of survivors was 889 (78.6%), while that of non-survivors was 242 (21.4%). Multivariate logistic regression analysis revealed that the PATHOS score (odds ratio [OR]: 3.80, 95% confidence interval [CI]: 3.07–4.70, p<0.001) independently predicted in-hospital mortality. According to the receiver operating characteristic analysis, the area under the curve of the PATHOS score was 0.827 (0.804–0.849). A PATHOS score greater than 2 predicted in-hospital mortality with a specificity of 75.9% and a sensitivity of 77.6%. Conclusion: The PATHOS score may serve as a valuable tool for predicting in-hospital mortality in geriatric patients admitted to the ICU from the ED. By effectively identifying critically ill elderly patients, this score may facilitate timely ICU transfers and contribute to the more efficient use of limited resources.