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Combining multiple comorbidities with Acute Physiology Score to predict hospital mortality of critically ill patients: a linked data cohort study
Author(s) -
Ho K. M.,
Finn J.,
Knuiman M.,
Webb S. A. R.
Publication year - 2007
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05231.x
Subject(s) - comorbidity , medicine , critically ill , charlson comorbidity index , intensive care medicine , cohort , severity of illness , apache ii , emergency medicine , intensive care unit
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.