BACKGROUND: To validate the use of the Charlson Comorbidity Index (CCI) for predicting admission of patients revisiting the Emergency Department (ED) within 72 hours. METHODS: Non-trauma patients aged above 17 years old who revisited an urban ED within 72 hours during January of 2004 were included in this retrospective observational study. Demographic data, diagnosis, CCI, in-hospital mortality rate and length of hospital stay were reviewed, and comparisons were made between the patients who were admitted or discharged on their return visits. RESULTS: Of the 168 enrolled patients, 60 were admitted to a ward and 108 were discharged. Revisiting patients with high CCIs (> or = 2) had a higher admission rate (67.3% vs. 22.7%; p < 0.001) and an increased adjusted odds ratio of admission (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.14-3.75) than low CCI patients. Admitted revisiting patients with high CCIs had poorer prognoses, longer hospital stays (11.79 +/- 8.92 days vs. 6.78 +/- 5.17 days; p < 0.05) and a higher in-hospital mortality rate (15.2% vs. 3.7%; p = 0.209). CONCLUSION: CCI was well correlated with the admission possibility of patients revisiting the ED within 72 hours. More clinical management and discharge strategies should target those revisiting patients who have more comorbidities.
BACKGROUND: To validate the use of the Charlson Comorbidity Index (CCI) for predicting admission of patients revisiting the Emergency Department (ED) within 72 hours. METHODS:Non-traumapatients aged above 17 years old who revisited an urban ED within 72 hours during January of 2004 were included in this retrospective observational study. Demographic data, diagnosis, CCI, in-hospital mortality rate and length of hospital stay were reviewed, and comparisons were made between the patients who were admitted or discharged on their return visits. RESULTS: Of the 168 enrolled patients, 60 were admitted to a ward and 108 were discharged. Revisiting patients with high CCIs (> or = 2) had a higher admission rate (67.3% vs. 22.7%; p < 0.001) and an increased adjusted odds ratio of admission (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.14-3.75) than low CCI patients. Admitted revisiting patients with high CCIs had poorer prognoses, longer hospital stays (11.79 +/- 8.92 days vs. 6.78 +/- 5.17 days; p < 0.05) and a higher in-hospital mortality rate (15.2% vs. 3.7%; p = 0.209). CONCLUSION: CCI was well correlated with the admission possibility of patients revisiting the ED within 72 hours. More clinical management and discharge strategies should target those revisiting patients who have more comorbidities.
Authors: Arjun K Venkatesh; Ying Dai; Joseph S Ross; Jeremiah D Schuur; Roberta Capp; Harlan M Krumholz Journal: Med Care Date: 2015-03 Impact factor: 2.983
Authors: Lauren T Southerland; Julie A Stephens; Shari Robinson; James Falk; Laura Phieffer; Joseph A Rosenthal; Jeffrey M Caterino Journal: J Am Geriatr Soc Date: 2016-04 Impact factor: 5.562
Authors: Lauren T Southerland; Daniel S Richardson; Jeffrey M Caterino; Alex C Essenmacher; Robert A Swor Journal: Am J Emerg Med Date: 2014-05-10 Impact factor: 2.469
Authors: Richard T Griffey; Sarah K Kennedy; Lucy D'Agostino McGowan; Lucy McGownan; Melody Goodman; Kimberly A Kaphingst Journal: Acad Emerg Med Date: 2014-10 Impact factor: 3.451
Authors: Shiying Hao; Bo Jin; Andrew Young Shin; Yifan Zhao; Chunqing Zhu; Zhen Li; Zhongkai Hu; Changlin Fu; Jun Ji; Yong Wang; Yingzhen Zhao; Dorothy Dai; Devore S Culver; Shaun T Alfreds; Todd Rogow; Frank Stearns; Karl G Sylvester; Eric Widen; Xuefeng B Ling Journal: PLoS One Date: 2014-11-13 Impact factor: 3.240