Comparison of HOTEL Score and Rapid Emergency Medicine Score (REMS) in Predicting Mortality of Geriatric Patients in Emergency Department of Saiful Anwar Hospital Malang


  • Taufiq Abdullah Fakultas Kedokteran Universitas Brawijaya
  • Sri Sunarti
  • Khalda Nabila



geriatric, early warning score, mortality


Background: Geriatric patients are elderly patients who have special characteristics, there are presence of degenerative diseases and decreased organ function due to the aging process. Geriatric patients tend to have a poor prognosis for a pathological condition that can lead to death. The Emergency Room as a place for first aid for emergency patients in a hospital must have a scoring system to predict the patient's condition. The scoring is intended to prepare for patient care so that patient mortality due to delays in treatment will be reduced. Prediction of mortality in geriatric patients in the ER can be done using HOTEL or REMS scoring. This study aims to determine the difference in the scoring ability of HOTEL and REMS in predicting mortality of geriatric patients in the emergency department of Saiful Anwar Hospital, Malang. Method: This study uses an observational analytic design based on the results of the Receiver Operating Characteristic analysis by looking at the area under the curve. Results: The sample of this study was geriatric patients in the ER RSSA Malang with a total of 518 patients who met the criteria based on inclusion and exclusion criteria. Conclusion: Based on the results of research at the ER RSSA Malang, the AUC values for HOTEL and REMS were 0.812 and 0.816, respectively. Both scores have a good ability to predict mortality in geriatric patients, but the REMS score has a higher AUC value and is more applicable and easy to use.

Keywords: Geriatric, Early Warning Score, Mortality.


Kemenkes RI. “Analisis Lansia Di Indonesia.” Pusat data dan informasi Kementerian Kesehatan RI: 1–2. 2017.

Rizka, Aulia, Kuntjoro Harimurti, Ceva W Pitoyo, and Sukamto Koesnoe. “Performa Rapid Emergency Medicine Score (REMS) Dalam Memprediksi Mortalitas 30 Hari Pasien Usia Lanjut Di Instalasi Gawat Darurat. 2017. ” Jurnal Penyakit Dalam Indonesia 4(2): 62.

Wahyuwidowati, Cekli, Cleopas M Rumende, and Ceva W Pitoyo. “Uji Validasi Skor HOTEL Sebagai Prediktor Mortalitas 24 Jam Pasien Nonbedah Di IGD.” 2015. 2(3).

Kellett, John, Breda Deane, and Margaret Gleeson. “Derivation and Validation of a Score Based on Hypotension, Oxygen Saturation, Low Temperature, ECG Changes and Loss of Independence (HOTEL) That Predicts Early Mortality between 15 Min and 24 h after Admission to an Acute Medical Unit.” Resuscitation. 2008. 78(1): 52–58.

Olsson, Thomas, Andreas Terent, and Lars Lind. “Rapid Emergency Medicine Score Can Predict Long-Term Mortality in Nonsurgical Emergency Department Patients.” Academic Emergency Medicine. 2004. 11(10): 1008–13.

Dundar, Zerrin Defne et al. “Rapid Emergency Medicine Score and HOTEL Score in Geriatric Patients Admitted to the Emergency Department.” International Journal of Gerontology. 2015. 9(2): 87–92.

Shekhli, Shabbir, Saikiran G., and Rajanikanth S. Malapur. “A Study of Initial Assessment of Emergency Patients Using REMS Score and HOTEL Score.” Indian Journal of Emergency Medicine. 2018. 4(4): 261–68.

Setiati, S. et al. “Geriatric Medicine, Sarcopenia, Frailty and Geriatric quality of Life: Future Challenge in Education, Research and Medical Srvice in Indonesia.” eJKI. 2013. 1(3): 234–242.

Alfana, M. A. F., Iffani, M. and Hanif, W. A. N. P. 2017. “Mortalitas di Indonesia (Sejarah Masa Lalu dan Proyeksi ke Depan).” Doi: 10.31219/

Bulut, M. et al. “The comparison of modified early warning score with rapid emergency medicine score: A prospective multicentre obsrbational cohort study on medical and surgical patients presenting to emergency department.” Emergency Medicine Journal. 2014. 31(6): 476–481.

Limantara, R. et al. “Faktor-faktor yang Mempengaruhi Tingginya Angka Kematian di IGD Rumah Sakit Factors Affecting High Mortality at Hospital's Emergency Room.” Jurnal Kedokteran Brawijaya. 2015. 28(2): 200–205.

Nolan, B. et al. “Rapid Emergency Medicine Score: A Critical Appraisal of Its Measurement Properties and Applicability to the Air Retrieval Environment.” Air Medical Journal. 2019. 38(3): 154–160.

Sunarti, S., Ratnawati, R. and Nugrahenny, D. “Prinsip Dasar Kesehatan Lanjut Usia (Geriatri).” 2019. Malang: UB Press.

Tanderup, A et al. “Disability and morbidity among older patients in the emergency department: A Danish population-based cohort study.” BMJ Open, 2018.8(12).



How to Cite

Abdullah, T., Sunarti, S., & Nabila, K. (2023). Comparison of HOTEL Score and Rapid Emergency Medicine Score (REMS) in Predicting Mortality of Geriatric Patients in Emergency Department of Saiful Anwar Hospital Malang. Jurnal Kedokteran, 12(2), 128–132.