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Objective To evaluate the primary diagnoses and patterns of 30 day readmissions and potentially avoidable readmissions in medical patients with each of the most common comorbidities.

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Nutritional risk screening (NRS 2002) is a strong and modifiable predictor risk score for short-term and long-term clinical outcomes: Secondary analysis of a prospective randomised trial, Clinical Nutrition,

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Background: Predicting long-term survival after admission to hospital is helpful for clin ical, administrative and research purposes. The Hospitalpa tient One-year Mortality Risk (HOMR) model was derived and internally validated to predict the risk of death within 1 year after admission. We conducted an external validation of the model in a large multicentre study. Methods:We used administrative data for all nonpsychiatric admissions of adult patients to hospitals in the provinces of Ontario (2003Ontario ( -2010 and Alberta (2011Alberta ( -2012, and to the Brigham and Women's Hospital in Boston (2010Boston ( -2012 to calculate each patient's HOMR score at admission. The HOMR score is based on a set of parameters that captures patient demographics, health burden and severity of acute illness. We determined patient status (alive or dead) 1 year after admission using population-based registries. Results:The 3 validation cohorts (n = 2 862 996 in Ontario, 210 595 in Alberta and 66 683 in Boston) were distinct from each other and from the derivation cohort. The overall risk of death within 1 year after admission was 8.7% (95% confidence interval [CI] 8.7% to 8.8%). The HOMR score was strongly and significantly associated with risk of death in all populations and was highly discriminative, with a C statistic ranging from 0.89 (95% CI 0.87 to 0.91) to 0.92 (95% CI 0.91 to 0.92). Observed and expected outcome risks were similar (median absolute difference in percent dying in 1 yr 0.3%, interquartile range 0.05%-2.5%). Interpretation:The HOMR score, calculated using routinely collected administrative data, accurately predicted the risk of death among adult patients within 1 year after admission to hospital for nonpsychiatric indications. Similar performance was seen when the score was used in geographically and temporally diverse populations. The HOMR model can be used for risk adjustment in analyses of health administrative data to predict long-term survival among hospital patients. Abstract Research 726CMAJ, July 14, 2015, 187(10) 4 We conducted an external validation of the HOMR model in a multicentre study that included Canadian and American hospitals. Methods Study settings and data sourcesWe used health administrative data from 2 Canadian provinces (Ontario and Alberta) and the Brigham and Women's Hospital in Boston. All data were linked and analyzed anonymously. The study was approved by the research ethics board at each study site (Sunnybrook and Women's College Health Sciences Centre Research Ethics Board, the University of Alberta Health Research Ethics Board and the Partners Human Research Committee).All health care activities in Ontario and Alberta are publicly funded and are captured in population-based administrative datasets. These datasets include the Discharge Abstract Database, which captures all hospital admissions and, in the years we sampled, used diagnostic codes from the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10); the Registered Per...