Hospital mortality prediction for intermediate care patients: Assessing the generalizability of the Intermediate Care Unit Severity Score (IMCUSS)
| Autor: | David N. Hager, Catherine E. Simpson, Juan Felipe Lucena, Varshitha Tanykonda, Zeba Noorain, Sarina K. Sahetya, Dale M. Needham |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Critical Care Critical Care and Intensive Care Medicine Severity of Illness Index Article External validity 03 medical and health sciences Young Adult 0302 clinical medicine Patient Admission Interquartile range Outcome Assessment Health Care Medicine Humans Generalizability theory Hospital Mortality Aged Retrospective Studies Receiver operating characteristic business.industry Reproducibility of Results 030208 emergency & critical care medicine Length of Stay Middle Aged Confidence interval Intensive Care Units Standardized mortality ratio 030228 respiratory system ROC Curve Spain Area Under Curve Models Organizational Cohort Emergency medicine Calibration Female business Intermediate care |
| Zdroj: | J Crit Care |
| ISSN: | 1557-8615 |
| Popis: | PURPOSE: The Intermediate Care Unit Severity Score (IMCUSS) is an easy to calculate predictor of in-hospital death, and the only such tool developed for patients in the intermediate care setting. We sought to examine its external validity. MATERIALS AND METHODS: Using data from patients admitted to the intermediate care unit (IMCU) of an urban academic medical center from July to December of 2012, model discrimination and calibration for predicting in-hospital death were assessed using the area under the receiver operating characteristic (AUROC) and the Hosmer-Lemeshow goodness-of-fit chi-squared (HL GOF X(2)) test, respectively. The standardized mortality ratio (SMR) with 95% confidence intervals (95% CI) was also calculated. RESULTS: The cohort included data from 628 unique admissions to the IMCU. Overall hospital mortality was 8.3%. The median IMCUSS was 10 (Interquartile Range: 0–16), with 229 (36%) patients having a score of zero. The AUROC for the IMCUSS was 0.72 (95% CI: 0.64–0.78), the HL GOF X(2) = 30.7 (P < 0.001), and the SMR was 1.22 (95% CI: 0.91–1.60). CONCLUSIONS: The IMCUSS exhibited acceptable discrimination, poor calibration, and underestimated mortality. Other centers should assess the performance of the IMCUSS before adopting its use. |
| Databáze: | OpenAIRE |
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