Combining multiple comorbidities with Acute Physiology Score to predict hospital mortality of critically ill patients: a linked data cohort study

Summary We investigated whether replacing the Acute Physiology and Chronic Health Evaluation (APACHE) II weighted comorbidity score with other measures of prior comorbidity would improve the prediction of hospital mortality in critically ill patients. Clinical data of 24 303 critically ill patients...

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Bibliographic Details
Published in:Anaesthesia 2007-11, Vol.62 (11), p.1095-1100
Main Authors: Ho, K. M., Finn, J., Knuiman, M., Webb, S. A. R.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
APACHE
Biological and medical sciences
Comorbidity
Critical care
Critical Illness - mortality
Hospital Mortality
Hospitals
Humans
Length of Stay - statistics & numerical data
Medical sciences
Middle Aged
Morbidity
Predictions
Prognosis
Severity of Illness Index
Survivor
Western Australia - epidemiology
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Summary:Summary We investigated whether replacing the Acute Physiology and Chronic Health Evaluation (APACHE) II weighted comorbidity score with other measures of prior comorbidity would improve the prediction of hospital mortality in critically ill patients. Clinical data of 24 303 critically ill patients were linked to the Western Australian hospital morbidity database to identify prior comorbidities. Minor comorbidities as described in the Charlson comorbidity index and Elixhauser comorbidities were prevalent in critically ill patients. Among 24 303 admissions, 3615 (14.9%), 10 223 (42.1%), and 11 597 (47.7%) patients had at least one comorbidity as defined in the APACHE II score, Charlson comorbidity index, and Elixhauser comorbidities, respectively. The ability of comorbidity alone to discriminate between hospital survivors and non‐survivors was poor. Replacing the APACHE II weighted comorbidity score with other more comprehensive measures of comorbidity did not significantly improve the discrimination of the APACHE II score.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2007.05231.x