All Patient Refined-Diagnosis Related Groups' (APR-DRGs) Severity of Illness and Risk of Mortality as predictors of in-hospital mortality

Data de publicação:

Autores da FMUP

  • Fernando José Oliveira Lopes

    Autor

  • José Alberto Da Silva Freitas

    Autor

  • Susana Isabel Oliveira Lopes

    Autor

Participantes de fora da FMUP

  • Santos, J.
  • Viana, J.
  • Pinto, C
  • Souza, J

Unidades de investigação

Abstract

The aims of this study were to assess All-Patient Refined Diagnosis-Related Groups (APR-DRG) Severity of Illness (SOI) and Risk of Mortality (ROM) as predictors of in-hospital mortality, comparing with Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) scores. We performed a retrospective observational study using mainland Portuguese public hospitalizations of adult patients from 2011 to 2016. Model discrimination (C-statistic/ area under the curve) and goodness-of-fit (R-squared) were calculated. Our results comprised 4,176,142 hospitalizations with 5.9% in-hospital deaths. Compared to the CCI and ECI models, the model considering SOI, age and sex showed a statistically significantly higher discrimination in 49.6% (132 out of 266) of APR-DRGs, while in the model with ROM that happened in 33.5% of APR-DRGs. Between these two models, SOI was the best performer for nearly 20% of APR-DRGs. Some particular APR-DRGs have showed good discrimination (e.g. related to burns, viral meningitis or specific transplants). In conclusion, SOI or ROM, combined with age and sex, perform better than more widely used comorbidity indices. Despite ROM being the only score specifically designed for in-hospital mortality prediction, SOI performed better. These findings can be helpful for hospital or organizational models benchmarking or epidemiological analysis.

Dados da publicação

ISSN/ISSNe:
0148-5598, 1573-689X

Journal of Medical Systems  Springer New York

Tipo:
Article
Páginas:
-
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 16

Citações Recebidas na Scopus: 15

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Keywords

  • In-hospital mortality; Prediction; Diagnosis-Related Groups; Severity of Illness; Risk of Mortality; Charlson Comorbidity Index; Elixhauser Comorbidity Index

Proyectos asociados

Stimulate continous monitoring in personal and physical health.

Investigador Principal: José Alberto da Silva Freitas

Estudo Observacional Académico (INNO4HEALTH) . FCT . 2021

A machine learning-based approach to support the assessment of clinical coded data quality in the context of Diagnosis-Related Groups classification systems

Investigador Principal: José Alberto da Silva Freitas

Estudo Clínico Académico . 2020

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