Publication:
Infections and internal medicine patients: Could a comorbidity score predict in-hospital mortality?

Loading...
Thumbnail Image

Date

2018-09-18

Authors

Fabbian, Fabio
De Giorgi, Alfredo
Boari, Benedetta
Misurati, Elisa
Gallerani, Massimo
Cappadona, Rosaria
Cultrera, Rosario
Manfredini, Roberto
Rodriguez Borrego, Maria A
Lopez-Soto, Pablo J

Advisors

Journal Title

Journal ISSN

Volume Title

Publisher

Wolters Kluwer Health
Metrics
Google Scholar
Export

Research Projects

Organizational Units

Journal Issue

Abstract

Infectious diseases (ID) are frequently cause of internal medicine wards (IMW) admission. We aimed to evaluate risk factors for in-hospital mortality (IHM) in IMW patients with ID, and to test the usefulness of a comorbidity score (CS).This study included ID hospital admissions between January 2013, and December 2016, recorded in the database of the local hospital. ICD-9-CM codes were selected to identify infections, development of sepsis, and to calculate a CS.We analyzed 12,173 records, (age 64.8 ± 25.1 years, females 66.2%, sepsis 9.3%). Deceased subjects (1545, 12.7%) were older, had higher percentage of sepsis, pulmonary infections, and endocarditis. Mean value of CS was also significantly higher. At multivariate analysis, the odds ratio (OR) for sepsis (OR 5.961), endocarditis (OR 4.247), pulmonary infections (OR 1.905), other sites of infection (OR 1.671), and urinary tracts infections (OR 0.548), were independently associated with IHM. The CS (OR 1.070 per unit of increasing score), was independently associated with IHM as well. The calculated weighted risk, obtained by multiplying 1.070 for the mean score value in deceased patients, was 19.367. Receiver operating characteristic (ROC) analysis showed that CS and development of sepsis were significant predictors for IHM (area under the curve, AUC: 0.724 and 0.670, respectively).Careful evaluation of comorbidity in internal medicine patients is nowadays matter of extreme importance in IMW patients hospitalized for ID, being IHM related to severity of disease, type and site of infection, and also to concomitant comorbidities. In these patients, a careful evaluation of CS should represent a fundamental step in the disease management.

Description

MeSH Terms

Adult
Aged
Female
Hospitalization
Humans
Internal medicine
Male
Middle aged
ROC curve
Retrospective studies
Risk factors
Severity of illness index

DeCS Terms

Bases de datos factuales
Comorbilidad
Curva ROC
Enfermedades transmisibles
Estudios retrospectivos
Factores de riesgo
Hospitalización
Medicina interna
Mortalidad hospitalaria

CIE Terms

Keywords

Communicable diseases, Comorbidity, Databases, factual, Hospital mortality

Citation

Fabbian F, De Giorgi A, Boari B, Misurati E, Gallerani M, Cappadona R, et al. Infections and internal medicine patients: Could a comorbidity score predict in-hospital mortality? Medicine (Baltimore). 2018 Oct;97(42):e12818