The risk of mortality and use of high-flow oxygen device based on respiratory distress clinical classification on emergency department admission: a retrospective study in Persahabatan Hospital, Jakarta

Abstract Background Rapidly assessing respiratory distress in emergency settings is challenging due to the limited availability of tools. We developed a clinical classification to identify and stratify patients with respiratory diseases based on symptom severity and aimed to evaluate its association with mortality and high-flow oxygen use. Methods This retrospective study included 126 emergency department patients. A Respiratory Distress Clinical Classification (RDCC) score was assigned based on consciousness, respiratory rate and oxygen saturation, categorising patients into mild, moderate, or severe distress. We analysed the association between RDCC and mortality as well as the use of high-flow oxygen devices. Results The study population included 9.5% with mild (n = 12), 40.5% with moderate (n = 51) and 50% with severe (n = 63) respiratory distress. The RDCC score was associated significantly with both the mortality (P < 0.001) and the use of high-flow oxygen devices (P < 0.001). Patients with severe distress had a higher risk of mortality (RR: 3.00; 95% confidence interval (CI): 1.61–5.60) and use of high-flow oxygen devices (RR: 5.40; 95% CI: 2.22–13.12) compared to those with mild-moderate distress. Comorbidities such as diabetes mellitus, liver and renal insufficiency significantly contributed to the mortality risk. Renal and cardiac insufficiencies may increase the risk of using high-flow oxygen devices. Conclusion The RDCC shows its potential as a simple, valuable tool for predicting mortality risk and high-flow oxygen devices needed in patients with respiratory distress, using only three variables. Further studies with larger samples are warranted to validate these findings.