scholarly journals The increased mortality associated with a weekend emergency admission is due to increased illness severity and altered case-mix

2011 ◽  
Vol 10 (4) ◽  
Author(s):  
Olga Mikulich ◽  
◽  
Elizabeth Callaly ◽  
Kathleen Bennett ◽  
Deirdre O’Riordan ◽  
...  
Keyword(s):  
Risk Model ◽  
Gastrointestinal Disease ◽  
Emergency Admission ◽  
Illness Severity ◽  
Case Mix ◽  
Inhospital Mortality ◽  
Unadjusted Odds Ratio ◽  
Co Morbidity ◽  
Multivariate Logistic Model ◽  
Illness Severity Score

Background: A weekend emergency medical admission has been associated with a higher mortality. We have examined all weekend admissions to St James’ Hospital, Dublin between 2002 and 2009. Methods: We divided admissions by weekday or weekend (Saturday or Sunday) presentation. We utilised a multivariate logistic model, to determine whether a weekend admission was independently predictive of 30 day outcome. Results: There were 49337 episodes recorded in 25883 patients; 30-day inhospital mortality at the weekend (9.9% vs. 9.0%) had an unadjusted Odds Ratio of 1.11 (95% CI 0.99, 1.23: p=0.057). In the full risk (unlike the univariate) model, a weekend admission was not independently predictive (OR 1.05; 95% CI: 0.88, 1.24). The case-mix for a weekend admission differed; with more neurological diagnoses (22.8% vs 20.4% : p = 0.001) and less gastrointestinal disease (18.3% vs 21.1% : p = 0.001). A biochemistry only illness severity score predicted a higher mortality for weekend admissions. Conclusion: Patients admitted at the weekend had an approximate 11% increased 30-day in-hospital mortality, compared with a weekday admission. However, admission at the weekend was not independently predictive in a risk model that included Illness Severity (age and biochemical markers) and co-morbidity. Sicker patients, with a worse outcome, are admitted over the weekend; these considerations should inform the allocation of healthcare resources.

External Validation of Pittsburgh Cardiac Arrest Category Illness Severity Score

Resuscitation ◽  
2021 ◽  
Author(s):  
Michelle M.J. Nassal ◽  
Dylan Nichols ◽  
Stephanie Demasi ◽  
Jon C. Rittenberger ◽  
Ashish R. Panchal ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Severity Score ◽  
External Validation ◽  
Illness Severity ◽  
Illness Severity Score

An illness severity score for multiple sclerosis

Neurology ◽  
1984 ◽  
Vol 34 (10) ◽  
pp. 1343-1343 ◽  
Author(s):  
M. R. Mickey ◽  
G. W. Ellison ◽  
L. W. Myers
Keyword(s):  
Multiple Sclerosis ◽  
Severity Score ◽  
Illness Severity ◽  
Illness Severity Score

scholarly journals Limited Prognostic Utility of a Simplified Vital Sign Based Risk Calculator in Acute Medical Admissions

2020 ◽  
Vol 19 (3) ◽  
pp. 138-144
Author(s):  
Richard Conway ◽  
◽  
Declan Byrne ◽  
Deirdre O’Riordan ◽  
Bernard Silke ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Vital Sign ◽  
Illness Severity ◽  
Polynomial Model ◽  
Inhospital Mortality ◽  
Risk Calculator ◽  
Major Disease ◽  
Fractional Polynomial ◽  
Prognostic Utility ◽  
Vital Parameters

Background: Accurate efficient prognostication in acute medical admissions remains challenging.Methods: We constructed a Vital Sign based Risk Calculator using vital parameters and Major Disease Categories to predict 30-day in-hospital mortality using a multivariable fractional polynomial model. Results: We evaluated 113,807 admissions in 58,126 patients. The Vital Sign based Risk Calculator predicted 30-day inhospital mortality to increase from 2 points – 3.6% (95%CI 3.4, 3.7) to 12 points – 14.8% (95%CI 14.0, 15.7). AUROC was 0.74 (95%CI 0.72, 0.74). The addition of illness severity and comorbidity data improved AUROC to 0.90 (95%CI 0.89, 0.90). Conclusion: The Vital Sign based Risk Calculator is limited by its simplicity; inclusion of illness severity and comorbidity data improve prediction.

scholarly journals Validation of the Pittsburgh Cardiac Arrest Category illness severity score

Resuscitation ◽  
2015 ◽  
Vol 89 ◽  
pp. 86-92 ◽  
Author(s):  
Patrick J. Coppler ◽  
Jonathan Elmer ◽  
Luis Calderon ◽  
Alexa Sabedra ◽  
Ankur A. Doshi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Severity Score ◽  
Illness Severity ◽  
Illness Severity Score

Acute Kidney Injury following Unselected Emergency Admission: Role of the Inflammatory Response, Medication and Co-Morbidity

2014 ◽  
Vol 126 (1) ◽  
pp. 81-89 ◽  
Author(s):  
T. Pankhurst ◽  
D. Mani ◽  
D. Ray ◽  
S. Jham ◽  
R. Borrows ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Inflammatory Response ◽  
Kidney Injury ◽  
Emergency Admission ◽  
Co Morbidity

scholarly journals Racial and Ethnic Disparities in Covid-19 Illness Severity Accounting for Concomitant Comorbidities: A Cohort Study

2020 ◽  
Author(s):  
Hongwei Ji ◽  
Natalie Achamallah ◽  
Nancy Sun ◽  
Patrick Botting ◽  
Peter Chen ◽  
...  
Keyword(s):  
African American ◽  
Intensive Care ◽  
Ethnic Disparities ◽  
Total Sample ◽  
Illness Severity ◽  
Racial And Ethnic Disparities ◽  
Hospital System ◽  
Racial And Ethnic Differences ◽  
Illness Severity Score ◽  
Differential Timing

Abstract Background Multiple reports have highlighted important racial and ethnic differences in the degree to which Americans may be vulnerable to severe forms of Covid-19 illness. Whether or not racial or ethnic disparities are related to variations in the underlying burden of comorbidities or other predisposing factors remains unclear.Methods We identified patients diagnosed with Covid-19, based on a positive PCR for SARS-CoV-2, from the electronic health record of a large multi-hospital system located in Southern California. We developed an illness severity score, based on the level of care each patient required (not admitted to the hospital; required hospital admission but never required intensive care; required intensive level care but never intubation; and, required intubation during hospitalization) and assessed for associations with clinical and demographic factors for each patient using ordinal logistic regression.Results A total of 571 patients with Covid-19 were identified a majority of whom were male (56%), with a mean age of 55±21 years. There were 81 (14%) patient who identified as African American, and 101 (18%) as Hispanic. A total of 202 (36%) patients required hospitalization without need for intensive care, 43 (8%) required intensive care without intubation, and 64 (11%) required intubation while also receiving intensive care. Of the total sample, African American race (OR 2.33, 95% CI 1.44-3.78, P=0.001) and Hispanic ethnicity (OR 1.97, 95% CI 1.14-3.12, P=0.004) were associated with greater illness severity.Conclusions Racial and ethnic disparities in the severity of Covid-19 illness persist, even when controlling for baseline comorbidities. It remains unclear if these differences are related to variations in physiologic response to SARS-CoV-2, differential timing of presentation or disparities in care.

Transport Risk Index of Physiologic Stability, Version II (TRIPS-II): A Simple and Practical Neonatal Illness Severity Score

2012 ◽  
Vol 30 (05) ◽  
pp. 395-400 ◽  
Author(s):  
Khalid Aziz ◽  
Michael Dunn ◽  
Maxine Clarke ◽  
Lajos Kovacs ◽  
Cecil Ojah ◽  
...  
Keyword(s):  
Severity Score ◽  
Risk Index ◽  
Illness Severity ◽  
Illness Severity Score
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