Disabling disease codes predict worse outcomes for acute medical admissions

Abstract

Disability burden, irrespective of organ system at emergency medical admission, independently predicts worse outcomes and a longer in-hospital stay.

Deprivation influences the emergency admission rate of ambulatory care sensitive conditions

“…In the multivariate model, we adjusted for previously determined outcome predictor variables of acute illness severity, 15,16 Charlson comorbidity index, 17 sepsis status 18 and chronic disabling disease score. 19 For LOS data, we employed a zero-truncated Poisson regression model including predictive categorical variables in the model as a series of indicator variables. We used robust standard errors for the parameter estimates.…”

Serum potassium levels as an outcome determinant in acute medical admissions

“…Comparisons between categorical variables and mortality were made using chi-square tests. The association between in-hospital mortality and serum potassium level, adjusted for age-adjusted acute illness severity score, 17,18 the Charlson comorbidity score, 12 disabling disease score, 15 O 2 saturation and Manchester triage status, 14 was examined. Logistic analysis of the binomial outcome variable was undertaken by fi tting a generalised estimating equation (GEE) regression model that allowed for clustered data; this is necessary to account for correlations between observations for a given subject (readmissions).…”

“…14 Disabling disease score has been demonstrated to be a predictor of mortality and therefore has been used as a risk adjustor in our multivariate model. 15,16 We have developed an acute illness severity score based on serum sodium, potassium, urea, albumin, red cell distribution width and white blood cell count, that predicts clinical outcomes. This has been used as a risk adjustor in our multivariable model.…”

Emergency readmissions are substantially determined by acute illness severity and chronic debilitating illness: A single centre cohort study

“…We assessed the ability of known predictors -acute illness severity [23,24], Charlson Co-morbidity Index [25], chronic disabling score [26] and the Manchester Triage System [27] to predict any readmission. Derangement of hemodynamic and physiological admission parameters has been utilised to derive an acute illness severity score (AISS) that predicts clinical outcomes [23,24,28].…”

“…We recently described a chronic disability score, derived from counts of discharge ICD9/ICD10 codes, that strongly correlated with mortality and length of stay [26]. Between January 2002 and December 2012 with 66,933 episodes in patients admitted as a medical emergency, who completed the hospital episode or suffered an in-hospital death by day 30, only 11.3% of such episodes had no disabling disease code.…”