دورية أكاديمية
أعرض في EDS

Present-at-admission diagnoses improved mortality risk adjustment among acute myocardial infarction patients.

التفاصيل البيبلوغرافية
العنوان: Present-at-admission diagnoses improved mortality risk adjustment among acute myocardial infarction patients.
المؤلفون: Stukenborg GJ; University of Virginia School of Medicine, Department of Public Health Sciences, Charlottesville, VA 22908, USA. gstukenborg@virginia.edu, Wagner DP, Harrell FE Jr, Oliver MN, Heim SW, Price AL, Han CK, Wolf AM, Connors AF Jr
المصدر: Journal of clinical epidemiology [J Clin Epidemiol] 2007 Feb; Vol. 60 (2), pp. 142-54. Date of Electronic Publication: 2006 Nov 13.
نوع المنشور: Comparative Study; Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 8801383 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0895-4356 (Print) Linking ISSN: 08954356 NLM ISO Abbreviation: J Clin Epidemiol Subsets: MEDLINE
أسماء مطبوعة: Publication: New York : Elsevier
Original Publication: Oxford ; New York : Pergamon Press, c1988-
مواضيع طبية MeSH: Hospital Mortality* , Logistic Models*, Myocardial Infarction/*diagnosis , Myocardial Infarction/*mortality, California ; Comorbidity ; Hospitalization ; Humans ; Prognosis ; Risk Assessment/methods
مستخلص: Objective: Hospital mortality outcomes for acute myocardial infarction (AMI) patients are a focus of quality improvement programs conducted by government agencies. AMI mortality risk-adjustment models using administrative data typically adjust for baseline differences in mortality risk with a limited set of common and definite comorbidities. In this study, we present an AMI mortality risk-adjustment model that adjusts for comorbid disease and for AMI severity using information from secondary diagnoses reported as present at admission for California hospital patients.
Study Design and Setting: AMI patients were selected from California hospital administrative data for 1996 through 1999 according to criteria used by the California Hospital Outcomes Project Report on Heart Attack Outcomes, a state-mandated public report that compares hospital mortality outcomes. We compared results for the new model to two mortality risk-adjustment models used to assess hospital AMI mortality outcomes by the state of California, and to two other models used in prior research.
Results: The model using present-at-admission diagnoses obtained substantially better discrimination between predicted survival and inpatient death than the other models we considered.
Conclusion: AMI mortality risk-adjustment methods can be meaningfully improved using present-at-admission diagnoses to identify comorbid disease and conditions related closely to AMI.
معلومات مُعتمدة: K02 HS11419 United States HS AHRQ HHS; R01 HS10134 United States HS AHRQ HHS
تواريخ الأحداث: Date Created: 20070109 Date Completed: 20070223 Latest Revision: 20071203
رمز التحديث: 20231215
DOI: 10.1016/j.jclinepi.2006.05.014
PMID: 17208120
قاعدة البيانات: MEDLINE
الوصف
تدمد:0895-4356
DOI:10.1016/j.jclinepi.2006.05.014