Early risk stratification and workflow acceleration in the emergency department: from thermal emergencies to triage-driven decision support
Ádám Kornél
Cardiovascular Medicine and Research Division
Dr. Merkely Béla
SE-ETK 138-as terem
2026-09-02 14:00:00
Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Dr. Merkely Béla
Dr. Varga Csaba
Dr. Élő Gábor
Dr. Bánfai Bálint
Dr. Székely Andrea
Dr. Zubek László
Dr. Betlehem József
Dr. Darvas Katalin
This dissertation summarises six original studies conducted in an emergency department in Budapest. The studies analyse how low-threshold triage variables, and a limited early laboratory panel, can improve risk stratification in thermal emergency conditions and aid in escalation decision-making in emergency care.
In the heat stroke study, three out of eight patients died in the emergency department. Early mortality was associated with significant acid-base and electrolyte disturbances, as indicated by admission arterial blood gas analysis. In cases of accidental hypothermia, the combination of the mandatory triage category and admission body temperature showed the highest point-estimate discrimination for early critical outcomes. In a second group of patients, levels of consciousness often differed from the temperature-defined severity — in a cohort with frequent alcohol use, sedatives, and psychiatric comorbidity — alongside characteristic patterns of comorbidity and drug co-occurrence.
According to the pilot data, there were differences in the biomarker and viscoelastic profiles during the rewarming process, which were indicative of the early clinical course. A machine learning model built on triage-level symptom data was able to predict laboratory orders in a simulated setting, with the potential to reduce the interval from triage to first laboratory order by one to two hours.
