Use of the All Patient Refined-Diagnosis Related Group (APR-DRG) Risk of Mortality Score as a Severity Adjustor in the Medical ICU.

Daniel Baram, Feroza Daroowalla, Ruel Garcia, Guangxiang Zhang, John J Chen, Erin Healy, Syed Ali Riaz, Paul Richman
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引用次数: 137

Abstract

Objective: To evaluate the performance of APR-DRG (All Patient Refined-Diagnosis Related Group) Risk of Mortality (ROM) score as a mortality risk adjustor in the intensive care unit (ICU).

Design: Retrospective analysis of hospital mortality.

Setting: Medical ICU in a university hospital located in metropolitan New York.

Patients: 1213 patients admitted between February 2004 and March 2006.

Main results: Mortality rate correlated significantly with increasing APR-DRG ROM scores (p < 0.0001). Multiple logistic regression analysis demonstrated that, after adjusting for patient age and disease group, APR-DRG ROM was significantly associated with mortality risk in patients, with a one unit increase in APR-DRG ROM associated with a 3-fold increase in mortality.

Conclusions: APR-DRG ROM correlates closely with ICU mortality. Already available for many hospitalized patients around the world, it may provide a readily available means for severity-adjustment when physiologic scoring is not available.

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使用所有患者精确诊断相关组(APR-DRG)死亡风险评分作为医学ICU的严重程度调节因子
目的:评价APR-DRG(所有患者精细诊断相关组)死亡风险(ROM)评分在重症监护病房(ICU)中作为死亡风险调节因子的作用。设计:回顾性分析医院死亡率。环境:位于纽约大都会的一所大学医院的重症监护室。病人:在2004年2月至2006年3月期间,有1213名病人入院。主要结果:死亡率与APR-DRG ROM评分升高有显著相关性(p < 0.0001)。多元logistic回归分析表明,在调整患者年龄和疾病组后,APR-DRG ROM与患者死亡风险显著相关,APR-DRG ROM每增加1个单位,死亡率增加3倍。结论:APR-DRG ROM与ICU死亡率密切相关。世界各地的许多住院患者已经可以使用,当生理评分无法获得时,它可能提供一种随时可用的严重程度调整手段。
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