RT Journal Article
T1 Infections and internal medicine patients: Could a comorbidity score predict in-hospital mortality?
A1 Fabbian, Fabio
A1 De Giorgi, Alfredo
A1 Boari, Benedetta
A1 Misurati, Elisa
A1 Gallerani, Massimo
A1 Cappadona, Rosaria
A1 Cultrera, Rosario
A1 Manfredini, Roberto
A1 Rodriguez Borrego, Maria A
A1 Lopez-Soto, Pablo J
K1 Communicable diseases
K1 Comorbidity
K1 Databases, factual
K1 Hospital mortality
AB 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.
PB Wolters Kluwer Health
YR 2018
FD 2018-09-18
LK http://hdl.handle.net/10668/13100
UL http://hdl.handle.net/10668/13100
LA en
NO 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
DS RISalud
RD Apr 10, 2025