Non-surgical in-hospital mortality predictors: a multivariable regression analysis of 2,855,029 hospitalizations

Walicka, Magdalena; Chlebuś, Marcin; Śliwczyński, Andrzej; Brzozowska, Melania; Rutkowski, D. Thomas; Czech, Marcin; Tuszyńska, Agnieszka; Jacyna, Andrzej; Puzianowska-Kuźnicka, Monika; Franek, Edward

doi:10.20452/pamw.15185

Cited by 4 publications

(7 citation statements)

References 16 publications

(16 reference statements)

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“…Elixhauser et al showed that in inpatients, comorbidities had independent effects on and were associated with longer hospitalization and mortality [9]. In turn, our previous study determined that, in patients who were hospitalized in nonsurgical departments, higher mortality was related to some factors associated with the hospitalization such as hospital type, type and day of admission, and length of hospital stay (comorbidities were not assessed) [10]. Likewise, the last published review [6] indicated that in the diabetes population, the problem of rehospitalization is complex because the risk factors of readmission can be related to the patient's medical condition such as certain comorbidities, abnormal laboratory values, inpatient hypoglycemia, hyperglycemia and glucose variability, low exercise capacity, as well as factors not related to the patient's medical condition such as insurance type, insulin treatment, length of hospitalization, and history of admissions.…”

Section: Introductionmentioning

confidence: 90%

Predictors of Rehospitalization and Mortality in Diabetes-Related Hospital Admissions

Kozioł

Towpik

Žůrek

et al. 2021

JCM

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The risk factors of rehospitalization and death post-discharge in diabetes-related hospital admissions are not fully understood. To determine them, a population-based retrospective epidemiological survey was performed on diabetes-related admissions from the Polish national database. Logistic regression models were used, in which the dependent variables were rehospitalization due to diabetes complications and death within 90 days after the index hospitalization. In 2017, there were 74,248 hospitalizations related to diabetes. A total of 11.3% ended with readmission. Risk factors for rehospitalization were as follows: age < 35 years; male sex; prior hospitalization due to acute diabetic complications; weight loss; peripheral artery disease; iron deficiency anemia; kidney failure; alcohol abuse; heart failure; urgent, emergency, or weekend admission; length of hospitalization; and hospitalization in a teaching hospital with an endocrinology/diabetology unit. Furthermore, 7.3% of hospitalizations resulted in death within 90 days following discharge. Risk factors for death were as follows: age; neoplastic disease with/without metastases; weight loss; coagulopathy; alcohol abuse; acute diabetes complications; heart failure; kidney failure; iron deficiency anemia; peripheral artery disease; fluid, electrolytes, and acid–base balance disturbances; urgent or emergency and weekend admission; and length of hospitalization. We concluded that of all investigated factors, only hospitalization within an experienced specialist center may reduce the frequency of the assessed outcomes.

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Section: Introductionmentioning

confidence: 90%

Predictors of Rehospitalization and Mortality in Diabetes-Related Hospital Admissions

Kozioł

Towpik

Žůrek

et al. 2021

JCM

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“…There were no differences between patients admitted on NWD as compared with WD in terms of length of hospitalization (5 [4][5][6][7][8] Figure 2A), whereas after the first year of follow-up mortality rate was 26.8% versus 19%, respectively (log-rank P=0.027, Figure 2A). Finally, all-cause long-term mortality was higher in patients who were treated at NWD versus at WD (36.3 vs 28.4%, log-rank P=0.037) ( Figure 2A).…”

Section: In-hospital and Long-term Mortality And Its Determinantsmentioning

confidence: 99%

“…In both groups no differences were found in baseline cardiac necrotic markers and in the distribution of insignificant lesions in coronary arteries in angiography (Table 4). The length of hospitalization in both MINOCA groups hospitalized on NWD and on WD was similar (4 [3][4][5] vs 4 [3][4][5][6][7] days, P=0.85, respectively). There were no in-hospital deaths in compared groups.…”

Section: Insight Into Minoca Populationmentioning

confidence: 99%

“…Despite the above-mentioned observations, there is no available data solely describing the relationship between the current organization of 24-hour/7-day cardiac catheterization laboratories in Poland and the long-term prognosis in MI patients admitted on non-working days. This problem has been partly raised by Walicka et al [6]. In their recently published study, the authors determined the predictors of in-hospital mortality based on the large number of 2 855 029 non-surgical hospitalizations [6].…”

Section: Introductionmentioning

confidence: 99%

“…This problem has been partly raised by Walicka et al [6]. In their recently published study, the authors determined the predictors of in-hospital mortality based on the large number of 2 855 029 non-surgical hospitalizations [6]. As has been shown vascular diseases were characterized by the highest mortality, whereas weekend admissions (Saturday: OR 1.40, 95% CI 1.36-1.43; Sunday: OR 1.29, 95% CI 1.26-1.32) and public holidays (OR 1.25, 95% CI 1.20-1.30) were characterized as independent predictors of in-hospital mortality.…”

Section: Introductionmentioning

confidence: 99%

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Worse long-term prognosis in myocardial infarction occurring at weekends or public holidays with insight into myocardial infarction with nonobstructive coronary arteries

Stępień¹,

Nowak²,

Nessler³

et al. 2020

Polish Archives of Internal Medicine

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This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited, distributed under the same license, and used for noncommercial purposes only.

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Predictors of short- and long-term mortality among acutely admitted older patients: role of inflammation and frailty

et al. 2021

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Background Frailty, demographic and clinical variables linked to incident diseases (e.g., dehydration, inflammation) contribute to poor outcomes in older patients acutely hospitalized. Their predictivity on short-, intermediate- and long-term mortality in a comprehensive model has been scarcely investigated. Aims To test the performance of a predictive tool considering frailty and inflammation as well as age, sex and impaired hydration status on 1-year mortality in acutely admitted older patients. Methods Retrospective observational study including 529 medical patients (age 84.6 ± 7.3 years). At hospital admission, frailty was assessed by the Multidimensional Prognostic Index (MPI). The Glasgow Prognostic Score (GPS) was used to grade systemic inflammation. Serum osmolarity was calculated to assess hydration. Results After adjusting for age, sex, GPS and osmolarity, the severe-risk MPI was a strong predictor for 1-year mortality (OR 4.133; 95% CI 2.273–7.516; p < 0.001). Age > 85 years, male sex, GPS-2 and serum osmolarity > 300 mOsm/L were independent predictors of mortality in the same multivariable model. The MPI alone showed a moderate discrimination power (AUC 0.678; 95% CI 0.628–0.729; p < 0.001) on 1-year mortality, which increased by 12.5% after the addition of the above predictors in the fully adjusted regression model (AUC 0.763; 95% CI 0.719–0.807; p < 0.001). The severe-risk MPI adjusted for the same factors was also an independent predictor of mortality after 60 and 180 days since hospital admission. Discussion Inflammation and impaired hydration are potentially modifiable risk factors for severe outcomes in older acutely hospitalized patients. A model combining GPS, age, gender, and plasma osmolarity improved the accuracy of MPI at admission in predicting long-term mortality.

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Non-surgical in-hospital mortality predictors: a multivariable regression analysis of 2,855,029 hospitalizations

Cited by 4 publications

References 16 publications

Predictors of Rehospitalization and Mortality in Diabetes-Related Hospital Admissions

Predictors of Rehospitalization and Mortality in Diabetes-Related Hospital Admissions

Worse long-term prognosis in myocardial infarction occurring at weekends or public holidays with insight into myocardial infarction with nonobstructive coronary arteries

Predictors of short- and long-term mortality among acutely admitted older patients: role of inflammation and frailty

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