# TeLePhone Respiratory (TeLePoR) score to assess the risk of immediate respiratory support through phone call for acute dyspnoea: a prospective cohort study

## TL;DR

This study developed a new scoring system called TeLePoR to help emergency call center dispatchers quickly identify patients with acute dyspnea who need immediate respiratory support.

## Contribution

The novel contribution is the derivation of the TeLePoR score, a simple tool based on four clinical variables to predict the need for respiratory support during emergency calls.

## Key findings

- The TeLePoR score includes four risk factors: altered speech, abdominal respiration, altered consciousness, and severe self-reported breathing discomfort.
- The score achieved an AUC of 0.810, showing good predictive accuracy for immediate respiratory support.
- Dispatcher intuition was not significantly better than the TeLePoR score in predicting the need for respiratory support.

## Abstract

Acute dyspnea is a frequent cause to call the Emergency Medical Call Center (EMCC). The main challenge for EMCC dispatchers is to quickly identify patients that will require respiratory support in order to provide them with the most accurate prehospital response. Our main objective was to derivate a score assessable during the first call to detect the most severe patients needing medical assistance.

This prospective observational cohort study was conducted in four different French EMCC from January 22nd to March 7th 2024. Patients over the age of 18 years old that called once the EMCC for acute dyspnea were included in our study. The primary endpoint was an immediate respiratory support requirement (i.e. high-flow oxygen, non-invasive ventilation or mechanical ventilation after intubation) before or at the Emergency Department Registration. Variables of interest to predict respiratory support were prospectively collected in each EMCC. A multivariate analysis by stepwise logistic regression was used to select variables associated with the primary endpoint and to create in the TeLePhon Respiratory Score (TeLePoR score). The TeLePoR score was compared to medical dispatcher intuition for predicting respiratory support.

Six hundred and forty-nine patients were analyzed, including 49 (8%) that required immediate respiratory support. The risk factors included in the TeLePoR score were: altered ability to speak complete sentences (OR = 8.62; CI95% = [3.49–21.3]), abdominal respiration (OR = 2.42; CI95% = [1.23–4.76]), altered consciousness (OR = 2.05; CI95% = [0.90–4.65]) and self-report breathing discomfort > 7/10 (OR = 1.83; CI95% = [0.96–3.47]) respectively. Considering these factors, TeLePoR score presented a 0.810 AUC. Medical dispatcher intuition was not statistically superior to TelePoR score to predict immediate respiratory support (AUC = 0.836 vs. 0.810; p = 0.431).

TeLePoR score is a simple scoring system including 4 variables to predict immediate respiratory support in patients calling the EMCC for acute dyspnea.

The online version contains supplementary material available at 10.1186/s13049-025-01405-3.