A modified Elixhauser score for predicting in-hospital mortality in internal medicine admissions

Autor: Alfredo De Giorgi, Roberto Manfredini, Ugo Fedeli, Fabio Fabbian, Marco Pala, Massimo Gallerani, Elisa Maietti, Rosaria Cappadona
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Population
Socio-culturale
Comorbidity
030204 cardiovascular system & hematology
Severity of Illness Index
Hospitals
University
03 medical and health sciences
Patient Admission
0302 clinical medicine
International Classification of Diseases
Internal medicine
Severity of illness
Internal Medicine
medicine
Humans
Hospital Mortality
030212 general & internal medicine
education
Aged
Quality Indicators
Health Care
Retrospective Studies
Aged
80 and over
education.field_of_study
Receiver operating characteristic
business.industry
Score
Regression analysis
Retrospective cohort study
Emergency department
Middle Aged
Prognosis
medicine.disease
Confidence interval
In-hospital mortality
Logistic Models
Italy
ROC Curve
Comorbidity
In-hospital mortality
Internal medicine
International Classification of Diseases
Score
Female
business
Zdroj: European Journal of Internal Medicine. 40:37-42
ISSN: 0953-6205
Popis: Background In-hospital mortality (IHM) is an indicator of the quality of care provided. The two most widely used scores for predicting IHM by International Classification of Diseases (ICD) codes are the Elixhauser (EI) and the Charlson Comorbidity indexes. Our aim was to obtain new measures based on internal medicine ICD codes for the original EI, to detect risk for IHM. Material and methods This single-center retrospective study included hospital admissions for any cause in the department of internal medicine between January 1, 2000, and December 31, 2013, recorded in the hospital database. The EI was calculated for evaluation of comorbidity, then we added age, gender and diagnosis of ischemic heart disease. IHM was our outcome. Only predictors positively associated with IHM were taken into consideration and the Sullivan's method was applied in order to modify the parameter estimates of the regression model into an index. Results We analyzed 75,586 admissions (53.4% females) and mean age was 72.7 ± 16.3 years. IHM was 7.9% and mean score was 12.1 ± 7.6. The points assigned to each condition ranged from 0 to 16, and the possible range of the score varied between 0 and 89. In our population the score ranged from 0 to 54, and it was higher in the deceased group. Receiver operating characteristic curve of the new score was 0.721 (95% CI 0.714–0.727, p Conclusions In order to make prognostic assessment, the use of a score could be of help in targeting interventions in older adults, identifying subjects at high risk for IHM.
Databáze: OpenAIRE
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