Placing clinical variables on a common linear scale of empirically based risk as a step towards construction of a general patient acuity score from the electronic health record: a modelling study
| Autor: | Alan B Solinger, Steven I. Rothman, Michael J. Rothman |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Pediatrics
medicine.medical_specialty Performance measures Health Informatics symbols.namesake Heart rate medicine business.industry Research Absolute risk reduction Regression analysis General Medicine Patient Acuity Community hospital Pearson product-moment correlation coefficient Mews Biotechnology & Bioinformatics symbols Early warning system business Quality measurement Demography |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2012-002367 |
| Popis: | Objective To explore the hypothesis that placing clinical variables of differing metrics on a common linear scale of all-cause postdischarge mortality provides risk functions that are directly correlated with in-hospital mortality risk. Design Modelling study. Setting An 805-bed community hospital in the southeastern USA. Participants 42302 inpatients admitted for any reason, excluding obstetrics, paediatric and psychiatric patients. Outcome measures All-cause in-hospital and postdischarge mortalities, and associated correlations. Results Pearson correlation coefficients comparing in-hospital risks with postdischarge risks for creatinine, heart rate and a set of 12 nursing assessments are 0.920, 0.922 and 0.892, respectively. Correlation between postdischarge risk heart rate and the Modified Early Warning System (MEWS) component for heart rate is 0.855. The minimal excess risk values for creatinine and heart rate roughly correspond to the normal reference ranges. We also provide the risks for values outside that range, independent of expert opinion or a regression model. By summing risk functions, a first-approximation patient risk score is created, which correctly ranks 6 discharge categories by average mortality with p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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