Specificity of the Ambulatory Simplified Acute Physiologic Score<br>—Experience of the Emergency Department of the Omar Bongo On-Dimba Army Training Hospital

Introduction: Mortality is a frequent phenomenom in emergency departement and a major public health concern. The use of mortality prognostic scores such as Ambulatory Simplified Acute Physiologic Score (ASAPS) remains a possibility to improve patient management in order to reduce mortality. Therefore, we proposed to conduct a study on patients admitted to our emergency department, in order to assess the ASAPS accuracy in our context. Patients and Method: This is a cohort, prospective, monocentric, descriptive and analytical study, during 4 months period in 2020. The study framework was in the Army Training Hospital Omar Bongo Ondimba (ATHOBO). We included all patients admitted in emergency room for at least 24 hours for a medical disease. The main purpose was to determine the ASAPS specificity in (ATHOBO) emergency department using the pivotal value of 8 points to do so. Results: During the study period, there were 3425 visits to emergency department among which we included 593 patients in the study. The patients’ average age was 47.37 ± 19.14 years. The sex ratio (M/W) was 1.16. The main reason for consultation was the flu-like syndrome in 15.18 % of cases. The admitted patients’ average ASAPS was 3.9 ± 3.22. The global mortality was 17.54%. For an ASAPS key value at 8, the specificity was 90.2% and the sensibility was 43.3%. Regarding the most seriously ill patients admitted in vital emergency reception room, the average ASAPS was 7 ± 2.9. The vital emergency reception room mortality was 37.16%. Conclusion: ASAPS is a nonspecific severity index, only based on clinical criteria. Our study showed a good ASAPS specificity and a good correlation between mortality and the score. However, this score has a bad sensibility due to the medical history and minimal blood test absence.